Medical Staff Voice

JW Moore- Tuesday, June 28, 2022, CME Conference “Short Course Antibiotic Therapy.”

Brad Spellberg, M.D., Chief Medical Officer of Los Angeles County-University of Southern California (LAC+USC) Medical Center and Professor of Medicine, will present a lecture on “Short Course Antibiotic Therapy.” At the end of the conference, the learner should be able to: 1) Identify the lack of evidence behind the standard duration of antibiotic therapy, 2) Recognize the optimal duration of treatment for many infections demonstrated with modern trials, and 3) Incorporate changes to antibiotic prescribing courses into clinical practice.

We will hold the conference on June 28, 2022, from 12:00 pm – 1:00 pm, 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 will be emailed to you.

EMPOWER Committee endorses Yogaworks 

• Submitted by Sandhya T. Patel, M.D., Ventura Coast Family Care

The Empower committee has been looking for more ways to support the medical staff. Yogaworks has offered a 3-month free trial (Usually it’s only 2 weeks).

Yogaworks is a digital experience offering dozens of daily live streams and on-demand yoga, fitness, Pilates, and meditation classes. Members can customize daily workouts by the time available, type of exercise, and skill level. It is a great way to practice from your own home. They have offered CMH staff a free 3-month trial.  I personally have been using this over the past year and have loved the different class selections for a good workout or restorative exercises.

Link to start a free trial.

New Password Requirements

As part of ongoing efforts to strengthen the security of our information systems, password requirements across the health system have been enhanced. The next time you are prompted to change your password, the new requirements will apply.  

What’s New

• Passwords must include four or more words.

What’s the Same

• Uppercase character(s) required
• Lowercase character(s) required
• Number(s) required Special character(s) required

Examples of Strong, Acceptable Passwords

• Tree@Window4RingExit
• CatR@SkyStation4Now
• Train^sNever4BeesGate

For questions regarding password requirements, please contact the Helpdesk at x5090 or helpdesk@cmhshealth.org.

Hospital admissions for Covid in countries with rising BA.4/5

As of last Tuesday, the CDC reported our BA.4/5 to be 35% of national COVID variants. By tomorrow’s report, the percentage should exceed 50%. (click on image to enlarge)

CMHS Weekly Medical Staff Calendar – June 27 – 24

Final Thoughts

“Success is not final, failure is not fatal. It is the courage to continue that counts.”
– Winston Churchill

Keep the faith,

JW Moore- Tuesday, Noon, CME Conference “New Radiotherapeutic Approached to Patients with Oligometastatic CA or Brain Metastases.”

Thomas Fogel, M.D., a local Radiation Oncologist, will present a lecture on “New Radiotherapeutic Approached to Patients with Oligometastatic CA or Brain Metastases.”

At the end of the conference, the learner should be able to: 1) Describe the spectrum of metastatic disease and the oligometastatic hypothesis, 2) Describe the evidence base for ablative “curative intent” treatments for oligometastatic disease, 3) Review the clinical trials that resulted from this new paradigm, 4) Examine the role of hippocampal avoidance for patients requiring whole-brain radiotherapy.

We will hold the conference on June 21, 2022, from 12:00 pm–1:00 pm, 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 invitation with a link to the meeting will be emailed to you.

Medical Staff Invitation for an Evening of Relaxation and Fun

To my Medical Staff colleagues:

 Did any of you professionally fight Covid over the past 2 1/2 years?

Were you stressed out that you yourself might get sick?

Did you worry about bringing it home to your family and friends?

If you answered ‘yes’ to any of the above, then I have ONE thing to say to you: THANKS!

What YOU have done throughout the COVID-19 pandemic is worthy of gratitude and genuine appreciation — and that’s exactly what our first “Friday Night Live” event of the Summer is all about, recognizing and celebrating our incredibly dedicated Medical Staff!

I hope you will join me and the rest of the EMPOWER committee along with the President of the Board of Trustees, CMHS Administration, and other community leaders for live music, appetizers from Paradise Pantry,  beer and wine, and your chance to win a raffle for a fancy dinner on us. Come after work and relax for a bit before going home!

When? Friday, June 24, from 4:30 – 7 pm
Where? Hunsinger Patio in the Mountain Tower at Community Memorial Hospital

RSVP to Tracey Shoop and be instantly enrolled in our raffle drawing: 805.948-5029 or tshoop@cmhshealth.org

PLEASE try to join us. You’ve earned it!

Jim Hornstein, MD, and the EMPOWER Committee

Epic EHR Demos – Early August

The IT department is currently planning vendor demos with our third and final EHR candidate, Epic. The demos are scheduled for the first week in August. We will announce details and the exact dates and schedule in a few weeks.

AMA’s Racism in Medicine Webinar

On June 29^th from 7 – 8:30 pm ET the American Medical Association will host a 90-minute webinar on the foundations of racism in medicine. Dr. Emily Cleveland Manchanda, the Director for Social Justice Education and Implementation at the AMA, will give a 60-minute didactic presentation followed by 30-minutes for Q&A. The presentation will include descriptions of:

1. Basic terminology around race and racism
2. Manifestations of racism in medicine at interpersonal, institutional, and systemic levels
3. Recommendations for additional reading and learning for physicians to continue their health equity education

We invite physicians and staff. The webinar will be uploaded to AMA’s EdHub and 1.0 CME credit will be offered.

If you are interested in attending this webinar, please register here. Registration is required to access the Zoom link for this event. If you have any questions, please do not hesitate to contact Kristina Hancock (Program Manager) at kristina.hancock@ama-assn.org.

US COVID New Hospitalization Rates Rising

Ventura County Positive Test Rate for COVID-19

In Memoriam – Dr. Leland Sprague

It is with great sadness to report the passing of Dr. Sprague. Dr. Sprague passed last Friday at the age of 91 years. He practiced for nearly 50 years as an anesthesiologist. He was the first anesthesiologist to be Chief of Staff at Community Memorial Hospital. Details of his funeral and/or memorial are pending.

CMHS Weekly Medical Staff Calendar – June 20 – 24

Final Thoughts 

“Nobody’s free until everybody’s free.”
– Fannie Lou Hamer

Keep the faith,

Final Thoughts 

“We have two lives, and the second begins when we realize we only have one.”
– Confucius

Keep the faith,

JW Moore CME Lecture canceled for the 3-Minute Scholarly Summary below;

Annual Resident 3-Minute Scholarly Summary

Please join us on June 7th, 2021, from 12-1:15 pm for our Annual Resident 3-Minute Scholarly Summary during the JW Moore time slot. This event allows residents to showcase their excellent scholarly work to the medical staff.

Join Zoom Meeting
https://us02web.zoom.us/j/88988001757?pwd=N096aGo0Y0RpNEtvbytXYUVZZUdOQT09&from=addon

Dial by your location
+1 669 900 9128 US (San Jose)

Neuroradiology Conference – Invitation from Dr. Nicholas Tarlov

We will have our next Neuroradiology Stroke Conference hosted by CMH on June 7th at 7:30 am via TEAMS. If you have interesting cases you would like to review with our neuroradiologist, Dr. Bates, and other colleagues, please submit the names and date of birth and the name and date of the study (example, MRI brain from 3/22/22) to Christina Nunez (cnunez1@cmhshealth.org) via email by June 1 so that she redact the names. Also, if you do not have the TEAMS software on your phone or computer, you can get it for the meeting. The IT Help Desk number is 805.652.5090 if you need that software.

Please contact Jennifer Howery, Stroke Coordinator, (jhowery@cmhshealth.org) to be added to the TEAMS meeting if you would like to attend.

Merge Imaging Software Loading of Images Time Delay

Many physicians complained about the slow or delayed loading of PACs images using the Merge PACs software. Keith McWilliams, CMHS CIO, met with the IBM Merge team and we just received an update that they have completed the corrective actions. We will monitor for the next two weeks and reach out again on June 17th.
If continued problems with delays in image loading occur, please email me and let me know.

GI PCR Panel – Changes in Testing

CMHS Stroke Rehabilitation Program

CMH Outpatient Neuro Rehab Team is available for most neurological disorder diagnoses referrals. All three disciplines of therapy, PT/OT/ST, will evaluate the referred patient and the team will work together to develop the plan of care. The therapy team approach is much like that at Rehab Centers, with collaboration, the common denominator working together for improved outcomes.

UCLA to pay record of nearly $700M in doctor abuse lawsuits

See something, say something. This was one topic brought up at last week’s Bioethics Committee. We have an obligation to our patients, our Oath, and one another to assure the safety of our patients.
Link to story details: $ 700 M settlement

New Omicron BA.4 & BA.5 wave hitting the US

Estimates released by the Centers for Disease Control and Prevention today indicate that the share of cases tied to Omicron variants BA.4 and BA.5 increased 79% in the past week. That means, even as the more transmissible BA.2.12.1 Omicron sub-variant became officially dominant in the U.S. last week, it’s already being pushed out by newcomers BA.4 and BA.5. The result would seem to be overlapping waves of Omicron.
“We now report findings from a systematic antigenic analysis of these surging Omicron sub-variants,” says a recent paper published to the BioRxiv preprint server. “BA.2.12.1 is only modestly (1.8-fold) more resistant to sera from vaccinated and boosted individuals than BA.2. On the other hand, BA.4/5 is substantially (4.2-fold) more resistant and thus more likely to lead to vaccine breakthrough infections.
”BA.4/5 are particularly good at escaping antibodies and reinfecting people previously infected with Omicron, as well as boosted individuals.”

BA.4/5 are more immune evasive and more virulent than current BA.2.12.1. They currently comprise about 6% of the Omicron infections in the US, after having appeared in the US just a few weeks ago. In Portugal and South Africa, they became the predominant COVID variant within two months and caused a fresh surge. Based on their doubling times, a new US/California surge might occur by mid to late July.

CMHS Hospital and Medical Staff are now becoming infected despite having had vaccines, boosters, and/or prior COVID infections. Let’s remain vigilant and continue the protective habits we’ve all learned, including the use of masks, hand sanitation, and distancing.

Link to the full news story

CMHS Weekly Medical Staff Calendar – June 6 – 10

Final Thoughts 

“Common sense is the collection of prejudices acquired by age eighteen.”
– Albert Einstein

Keep the faith,

JW Moore- Tuesday, May 24, 2022, CME Conference “ADHD Across the Lifespan.”

Jeffrey Newcorn, M.D., Professor of Psychiatry and Pediatrics at Icahn School of Medicine at Mount Sinai, will present a lecture on “ADHD Across the Lifespan.” At the end of the conference, the learner should be able to: 1) Discuss the clinical presentation of ADHD in children and adults, 2) Recognize that ADHD is a neurobiologically based neurodevelopmental disorder, 3) Distinguish ADHD from other disorders, 4) Discuss the range of treatments available for ADHD, and 5) Explain how to implement treatment for ADHD.

The conference will be held on May 24, 2022, from 12:00 pm – 1:00 pm, 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 will be emailed to you.

PACS Imaging in PatientKeeper (PK) Update Wednesday, June 1st

IT intends to update the PACS launch in PatientKeeper  Wednesday, 6/1 at 0530 AM

Current-State:
If a Physician viewing Imaging Reports in PatientKeeper wants to see the image, they can click a PACS link to launch the ‘ZDA’ viewer.

Future-State:
On Thursday, 5/26 we will update the PACS link to launch the same images but in our newer PACS viewer called ‘iConnect’.

 Take-aways:
The functionality will remain the same – Physicians will be brought directly to the image(s) they are reading. However, there will be some nuance if navigating in iConnect vs. ZDA.

Images of Differences between old/new image viewers

PACS Imaging Systems Changes affecting CMHS and Grossman Imaging

PatientKeeper (PK) Downtime

Tuesday, May 24^th, 12:01 am-4 am – Part 2 of DBMotion update, PK to be unavailable during this time – 4 hours total.

PatientKeeper ‘Level of Decision Making’ query now optional per Specialty

Take Action: Vote No on AB 2060 – Keep the Medical Board of California a physician member majority!

Your advocacy is impactful! Legislators are hearing from their local physicians about the negative impacts of changing the composition of the Medical Board of California to a public member majority.

You prevented AB 2060 from receiving an Assembly floor vote this week; however, the author still has one final week to try to get the bill passed by the full Assembly. Your renewed advocacy during the week of May 23 will be the difference between stopping the bill on the Assembly floor and having the bill move forward to the Senate.

CMA urges your continued action, and we appreciate your voice in opposing AB 2060.

Please click here today to send an email to your Assemblymember asking them to vote “No” on AB 2060.

Households can order 8 more free at-home COVID-19 tests

U.S. residents can order online eight more free at-home tests for COVID-19, the White House announced. People who have difficulty accessing the internet or need additional support can order the tests by phone. The U.S. Postal Service has delivered about 350 million free at-home tests to households since January, with the latest round funded by the American Rescue Plan Act.

Save the Date: October 8, 2022 Benefactors’ Ball

Supporting Community Memorial Hospital

 The Benefactors’ Ball
Saturday, October 8^th
Commemorative Air Force Museum, Camarillo
5:00 PM Cocktail Reception
6:00 PM Dinner, Cephas Bard, MD Awards, Live Auction & Dancing

 The Community Memorial Healthcare Foundation is proud to present the 48th annual Benefactors’ Ball. We invite you to sit back, relax, and join the friendly skies for a delightful evening of sharing valued friendships, fine cuisine, and music that makes us want to take off and dance.

 The Benefactors’ Ball has a rich history of supporting the hospital’s greatest needs such as cutting-edge equipment and funding vital programs and services. Your support of this year’s event will propel us into the future and keep CMH a strong medical facility that is ready to serve our community now and for generations to come.

 For tickets and sponsorship opportunities, visit: https://www.benefactorsball.org/

Or contact Lindsey Stetson: 805-948-4253 or lstetson@cmhshealth.org

We are so grateful for your support of the Foundation over the years!

Lindsey K. Stetson
Associate Major Gifts Officer | Community Memorial Healthcare Foundation
805-948-4253 | lstetson@cmhshealth.org

Contrast for Imaging Supply Chain Update – We received this letter from our supplier

May 10, 2022

Dear Valued Customer,

As you may know, one of the major US suppliers of iodinated contrast media in the United States is currently experiencing a supply shortage due to the stringent COVID restrictions in Shanghai. On May 6^th, the American College of Radiology (ACR) posted a statement addressing this worldwide shortage; please review the message at this link for ACR’s guidance on how to manage your practice.

These restrictions are not impacting Bracco products supplying the North American market. Given the shortage of this major supplier, over the past week, Bracco has experienced an influx of orders from facilities looking to purchase Isovue^® (iopamidol injection).

Bracco has taken several measures to protect our Isovue inventory and to ensure we have enough product for our committed customers like you. These measures include investing in increased Isovue manufacturing capacity, a focus on manufacturing our high-volume SKUs and implementation of a direct purchase model to allow for more control of inventory. At this time, we do not anticipate any Isovue issues in the foreseeable future and will continue to monitor this situation.

Today, in order to ensure that we maintain a steady supply for you and your patients, we have implemented a new process for our existing committed customers.

What does that mean?

·    Effective last week, we started an order review process to ensure our committed customers are receiving product.

·    Starting today, BDI systems are in place to process orders based on your facilities’ average order quantity. These orders will be processed immediately and will be shipped within your contracted shipping timeframe.

·    Any orders over that quantity will be placed on hold and manually reviewed. If large stocking orders are placed, there will be a delay of approximately one week for processing, and the order will be fulfilled at your average order quantity; the remaining order quantity will be canceled.

How can you help?

·    Place orders in the normal process and quantity for your facility.

·    Do not place large stocking orders as they will strain the system and cause delays for you and other facilities

CMHS Weekly Medical Staff Calendar – May 23 – 27

Final Thoughts 

“You, yourself, as much as anybody in the entire universe, deserve your love and affection.”
– Buddha

Keep the faith,

JW Moore – Tuesday, Noon, CME Conference “Childhood Adversity Lasts a Lifetime.”

Danielle Shaw, M.D., FAAP, FAPA, local Pediatrician and Child & Adolescent Psychiatrist,  will present a lecture on “Childhood Adversity Lasts a Lifetime.” At the end of the conference, the learner should be able to: 1) Define Adverse Childhood Experiences (ACEs) and their prevalence, health disparities in these data, toxic stress response, and related impacts on health, including underlying biological mechanisms, 2) Evaluate patients in your specialty with ACE-Associated Health Conditions to assess for a possible contribution of toxic stress to the presenting symptoms, regardless of the age of the patient, 3) Assess for both physical and behavioral responses to trauma, 4) List three new presentations of a trauma you will utilize to assess a toxic stress etiology for the patient’s symptoms in your practice, and 5) Incorporate Stress Busters in your treatment plan to buffer the effects of toxic stress.

The conference will be held on May 17, 2022, from 12:00 pm – 1:00 pm, 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 will be emailed to you.

CMHS Quarterly General Medical Staff Meeting

Ventura County Star Guest column: “We must keep fighting for immunizations”

Decades ago, polio was the most formidable and notorious disease in the United States. Outbreaks occurred regularly through the 1950s, with one of the most significant epidemics occurring in 1952.

Case Management Services Improving Patient Continuity and Quality of Care

CMHS Weekly Medical Staff Calendar – May 16 – 20

Final Thoughts 

“Wealth consists not in having great possessions, but in having few wants.”
– Epictetus

Keep the faith,

JW Moore- Tuesday, Noon, CME Conference “LGBTQ Cases Illustrating Effective Approaches to Care.”

Robert Morris, M.D. board certified in pediatrics and adolescent medicine and Professor Emeritus of Pediatrics at David Geffen School of Medicine at UCLA, will present a lecture on “LGBTQ Cases Illustrating Effective Approaches to Care.” At the end of the conference, the learner should be able to: 1) Illustrate an approach to rejecting families, its consequences, and effective interventions, 2) Describe clinician behaviors to avoid, 3) Describe how to reconcile religious beliefs and Homosexuality, 4) Describe methods to communicate about sex and sexual orientation, 5) Identify recommended sexually transmitted infection testing, and 6) Define pre-exposure prophylaxis, who should get it, and labs to obtain before beginning PrEP.

The conference will be held on May 10, 2022, from 12:00 pm – 1:00 pm, 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 will be emailed to you.

CMHS Quarterly General Medical Staff Meeting

PatientKeeper (PK) Downtime Tonight

A reminder that starting after midnight tonight will be our first of two work efforts requiring PK downtime. These will be required to update PK’s database, see below:

1. Tuesday, May 10^th, 12:01 am-4 am – Part 1 of DB update, PK to be unavailable during this time
2. Tuesday, May 24^th, 12:01 am-4 am – Part 2 of DB update, PK to be unavailable during this time

A system broadcast tonight to alert users. An additional reminder will be sent before the 5/24 downtime.

Termination of the UCLA Hospitalist Program at CMH

We have just received an announcement from the UCLA Hospitalist Service Director, Dr. Michael E. Lazarus, M.D., that as of May 9, 2022, they have decided to close the UCLA Internal Medicine (Hospitalist) service at CMHS for the emergency department and direct admissions with immediate effect.  They will continue to provide coverage to all existing inpatients until they have been successfully discharged. They’ve asked that the Emergency Department direct any new UCLA admissions to the panel physicians with immediate effect. The UCLA Primary Care Providers and Sub-Specialists have been informed of their plan to draw down the service.

National Hospital Week Celebrations at CMHS!

MICRA 2022: A Sustained Era of Stability – Historic Agreement!

For decades, California’s landmark medical malpractice laws have successfully struck a balance between compensatory justice for injured patients while maintaining an overall health care system that is accessible and affordable for Californians.

During that time, California’s physician and provider communities, through Californians Allied for Patient Protection (CAPP), have defended the Medical Injury Compensation Reform Act (MICRA) through expensive battles at the ballot, in the courtroom, and in the legislature. CAPP is the large and diverse coalition working to protect access to health care through MICRA. Its membership includes the California Medical Association (CMA), California Hospital Association, California Dental Association, CMA’s component medical societies, medical malpractice insurance carriers, community clinics, Planned Parenthood Affiliates of California, and many more.

This year, with the so-called Fairness for Injured Patients Act (FIPA) slated for the November ballot, we are again facing another costly initiative battle that could obliterate existing safeguards for out-of-control medical lawsuits and result in skyrocketing health care costs.

Now, for the first time in a generation, we were met with an opportunity to achieve a meaningful consensus between competing interests through a revised framework that could protect both the rights of injured patients while keeping MICRA’s essential guardrails solidly in place for patients and providers alike.

At times like these, we have an obligation to protect patient care and to seize a historic opportunity for a brighter future for California’s health delivery system.

To that end and at long last, a historic agreement to modernize MICRA is on the horizon. The two sides of the ballot measure campaign have committed to putting patients first, to prioritizing the stability of affordable access to health care, and to set aside differences to do what’s right for all Californians.

As part of this modernization of MICRA, it was important that the underlying principles be preserved – ensuring access to care and protecting our health care delivery system from runaway costs. Important guardrails of MICRA will continue unchanged, including advance notice of a claim, the one-year statute of limitations to file a case, the option of binding arbitration, early offers of proof for making punitive damages allegations and allowing other sources of compensation to be considered in award determinations.

The element likely to garner the most interest surrounds changes to the limit on non-economic damages in medical malpractice cases, which is currently $250k. As opposed to the ballot measure, which would have effectively eliminated the cap on non-economic damages entirely, under the agreement:

• Cases not involving a patient death will have a limit of $350k on the effective date of January 1, 2023, with an incremental increase over the next 10 years to $750k and a 2.0% annual inflationary adjustment thereafter.
• Cases involving a patient death will have a limit of $500k on the effective date of January 1, 2023, with an incremental increase over the next 10 years to $1 million and a 2.0% annual inflationary adjustment thereafter.

Critical MICRA guardrails that will remain in place with modest updates include the ability to pay awards of future damages over time and limits on plaintiff’s attorney’s contingency fees.

Our coalition is working with the Newsom Administration and leaders of the California Legislature to pass legislation that will make this new policy California law. Under the agreement, the initiative will be withdrawn from the ballot and this watershed agreement will preclude another costly fight.

Click here to read the joint statement from our coalition, CAPP, and proponents of FIPA.

Best wishes for a healthy future,

Robert E. Wailes, M.D.
President, California Medical Association

Dodger Baseball sponsored by the EMPOWER Committee

This event is sponsored by the EMPOWER Committee, “Employment of Metrics for the Promotion Of Wellness and the Enhancement of Resilience” (EMPOWER).  Our purpose is to advocate and promote opportunities to optimize the Medical Staff’s well-being. The EMPOWER members focus efforts on improving CMHS workflow and processes that influence individual physicians’ health and engagement.

CMHS Weekly Medical Staff Calendar – May 9 – 13

Final Thoughts 

“Character, not circumstances, makes the man.”
– Booker T. Washington

Keep the faith,

JW Moore- Tuesday, Noon, CME Conference “Wilderness Medicine: Snakes, Spiders, Scorpions & Heat Too”

Sean Nordt, M.D., Pharm.D., Attending Physician at LAC USC Medical Center Keck School of Medicine, will present a lecture on “Wilderness Medicine: Snakes, Spiders, Scorpions & Heat Too.” At the end of the conference, the learner should be able to: 1) Become familiar with the presentation and treatment of rattlesnake envenomation, 2) Describe spider and scorpion clinical effects and treatment, and 3) Develop an approach to treating heat-related illness.

The conference will be held on May 3, 2022, from 12:00 pm – 1:00 pm, 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 will be emailed to you.

MSV – LIVE! – Season 3, Episode 5, Dr. Jill Hall | Urogynecology

In this week’s episode of Medical Staff Voice LIVE, Dr. Stan sits down with Dr. Jill Hall, Urogynecology.
Native to southern California, Dr. Hall received her Bachelor of Science degree in Neuroscience at Brown University in Rhode Island. She received her medical degree at USC’s Keck School of Medicine. She completed her residency in obstetrics and gynecology at UCLA and a fellowship at Long Beach Memorial Hospital. Dr. Hall describes urogynecology as a combination of urology and gynecology and treats problems stemming from urinary incontinence, fecal incontinence, bladder, and pelvic organ prolapse.
Outside of work, Dr. Hall can be found coaching volleyball for her daughters’ teams!
Link to YouTube video interview

Special Faculty Development Event Sponsored by The EMPOWER Committee at CMHS:

Wednesday, May 4th, 2022, CME Conference “Re-inventing Your Practice: Making Changes in Your Medical Career.”

Debra Phairas, MBA, President of Practice & Liability Consultants, LLC, and Jim Hornstein, M.D. Family Medicine Practitioner and Bioethics Chair at CMHS & VCMC will present a lecture on “Re-inventing Your Practice: Making Changes in Your Medical Career.” At the end of the conference, the learner should be able to: 1) Recognize the signs of physician burnout and learn prevention strategies, 2) Acknowledge the connection between physician burnout and decreased quality of patient care, and 3) Re-invent the practice for increased satisfaction for the physician and patient.

The conference will be held on Wednesday, May 4th, 2022, from 6:00 pm – 7:00 pm, via ZOOM. This activity qualifies for 1.0 AMA PRA Category 1 Credit™ & 1.0 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 will be emailed to you.

C. difficile by PCR – New CMHS Lab reporting format

Effective May 16, 2022, the C. difficile PCR assay will auto reflex to an EIA test for the detection of C. difficile glutamate dehydrogenase (GDH) antigen (Ag) and toxins A and B for all samples that are reported as positive.

This reverse two-step algorithm will aid in differentiating between patients who are colonized with C.diff and those who are actively infected.

For all specimens that test positive for the C. difficile PCR assay, the following tests will be reported:

• PCR
• 027/NAP1/B1 (hyper-virulent C.diff strain)
• C. diff GDH AG (glutamate dehydrogenase antigen)
• Toxin A&B: detects toxin production, an indicator for active infection

Example of reports:

From PK: (click on image to enlarge)

Reporting interpretations and suggested patient management:

For additional information, please contact the microbiology department at 805.948.6134.

Dr. Meeae Kwon
Medical Director, Community Memorial Hospital Laboratory

Healthcare professionals experiencing moral injury similar to combat veterans

During the COVID-19 pandemic, healthcare workers have experienced moral injury at levels comparable to combat veterans, according to new research published in the Journal of General Internal Medicine. The research is based on information gathered from 618 veterans who served in a combat zone after September 11, 2001, and 2,099 healthcare workers who have provided care during the pandemic.

Moral injury has been defined as the “psychological, biological, spiritual, behavioral and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations.” The new research examined two kinds of potential moral injury:

• Other-induced potential moral injury, which involves being disturbed by the immoral acts of others
• Self-induced potential moral injury, which involves being disturbed by violating your own morals

According to HealthLeaders, the study revealed several key data points:

• 46.1% of combat veterans and 50.7% of healthcare workers reported other-induced potential moral injury
• 24.1% of combat veterans and 18.2% of healthcare workers reported self-induced potential moral injury
• For healthcare workers, the other-induced potential moral injury was linked to younger age and COVID-19 exposure
• For healthcare workers, the self-induced potential moral injury was linked to younger age, nonwhite race, working in a high-risk setting, and COVID-19 exposure
• Healthcare workers who reported other-induced potential moral injury had higher levels of depression and lower quality of life compared to healthcare workers who did not report other-induced potential moral injury
• Healthcare workers who reported self-induced potential moral injury had higher levels of depression and lower quality of life compared to healthcare workers who did not report the self-induced potential moral injury
• Healthcare workers who reported other-induced or self-induced potential moral injury experienced significantly higher levels of burnout compared to healthcare workers who did not report the other-induced or self-induced potential moral injury

Of course, it’s not the first study to show increasing levels of burnout and moral injury connected to the pandemic. A 2022 study from KLAS found that pre-pandemic, 25% of clinicians reported some degree of burnout. Now, the number has risen to 33%. Additionally, a 2021 study from the Jackson Physicians Search found that 36% of surveyed physicians planned to either take early retirement or leave the medical profession entirely. In short, the pandemic has put tremendous pressure on healthcare workers, and its effects will likely have a lasting impact on healthcare well into the future.

Celebrate Nurses Week & Nurses Day, May 5th

CMHS Weekly Medical Staff Calendar – May 2 – 6

Final Thoughts 

“What the world really needs is more love and less paperwork.”
– Pearl Bailey

Keep the faith,

JW Moore Tuesday, Noon, CME Conference is Cancelled Tomorrow.

MSV – LIVE! Season 3, Episode 4, Dr. Baijia Jiang, Hematology-Oncology

We are back with another episode of Medical Staff Voice LIVE! with Dr. Stan Frochtzwajg. In this week’s episode, we’re joined by Dr. Baijia “Yoyo” Jiang, a hematologist oncologist with Ventura County Hematology Oncology Specialists.

Born and raised in Maryland, Dr. Jiang attended undergrad and medical school at the University of Maryland, before attending her internship and residency in San Francisco. Following her medical training in northern California, Dr. Jiang returned to the east coast and completed a fellowship in Hematology/Oncology at Virginia Commonwealth University.

Outside of work, Dr. Jiang enjoys cooking, running, and exploring all of the trails that Ventura County has to offer! Plus, we learn something NEW about Dr. Jiang that her patients might not know.

Link to YouTube video interview

Outpatient Physician Referrals to CMHS Emergency Departments

The Emergency Physicians at CMH Ventura and Ojai would like to thank our outpatient physician partners for the excellent job they do at communicating with us when they send their patients to the ED. It is so helpful to get some background information on these patients. While we are talking to you, we are able to enter the info into our EHR which then seamlessly merges with the patient’s chart when they arrive at triage. This form of communication is also helpful for us to make sure that these patients will receive the treatment that they need. For instance, we do have occasional holes in sub-specialty coverage such as ENT and ophthalmology. If we do not have an ophthalmologist on-call at our facility we can direct the patient to the appropriate facility. We can also assist with arranging outpatient blood transfusions as well as paracentesis next-day procedures. Thanks again, from your appreciative partners in the ER.

Chris Johnson, MD
Medical Director
CMH Emergency Department
Ventura
cell: 805 717-4697

Meditech and Cerner Recorded Demos Online

The EHR Demos (Meditech and Cerner) have been recorded by the IS Department. They can all be found on the CMHS Intranet, at the top of the home page. Access to the Intranet is only available on the CMHS Campus.

The Epic Demo is still pending and we will advise you as soon as it is scheduled.

Medical Staff Yearly PPDs by May 31, 2022 – Medical Staff Services

It is the policy of Community Memorial Health System to require TB testing of all physicians and Allied Health Professionals at appointment and annually in accordance with the CA Department of Health Services recommendation.  All Medical Staff and Allied Health Professional Staff members are required to submit the following on or before the month’s end of the previous TB test results: 1) Current PPD results OR 2) Quantiferon TB titer OR 3) If TB positive, a completed TB Questionnaire (attached).  Repeat x-rays will not be required unless symptomatic.  Annual TB results will be considered delinquent one year following the month’s end of the previous TB test results.

PPD tests are available through the hospital’s Occupational Health Department or may be done in the practitioner’s offices or another healthcare facility.  PPD tests must be read within 48-72 hours after the test is administered by a practitioner qualified to read PPDs. A practitioner may not serve as his/her test interpreter or interpret his/her own x-rays.  The Occupational Health Department telephone number is (805) 667-2886.

Failure to submit a current TB record will result in the suspension of clinical privileges.  If suspended, the practitioner will automatically be off-staff once a 90-days suspension has been reached.

Allied Health Professionals – you will need to sign a release with Occupational Health in order for them to forward documentation to us.

If you have any questions, please feel free to call the Medical Staff Office at (805) 948-5662.  You can fax the PPD records to fax number (805) 648-4295 (call the Medical Staff Office to confirm receipt) OR e-mail them to CREDENTIALS@CMHSHEALTH.ORG

April PPD Clinics CMHS

May PPD Clinics CMHS

Medical Staff/Allied Health Tuberculosis Screening Form

Doctor’s Parking Area in West Parking Structure

The Medical Staff has been using the Doctor’s parking spaces on the second floor. We are increasing surveillance to verify that the cars parked there have the Medical Staff placard. If you need a placard, please pick it up from the Medical Staff Office on the 8th floor of the Mountain Tower. Enforcement of the parking placards will increase.

Because the open Doctor’s parking lot on Brent is sparsely used, we are considering converting much of it to patient parking.

Webinar: Thriving in Practice Through Value-Based Care – Thurs. April 28

With growing value-based care contracts, more physicians are taking the leap into the world of value-based care, but not all are succeeding. The complexities of managing changing benchmarks, different payor relationships, and decreasing fee-for-service revenue are putting a strain on primary care physicians and health centers that have already seen anywhere from a 10-30% decrease in revenue due to the pandemic. In this practical session with CMA Vice President of Health Information Technology David Ford and partner organization Aledade, learn the tools necessary to ensure that your practice or health center takes the steps required to succeed this year.

1. Consider the basics of value-based care, what metrics matter, and how to thrive.
2. Evaluate your practice or health center workflows and share ideas to improve outcomes for patients.
3. Identify barriers and blockers that hinder advancement in value-based care.
4. Develop a concrete action plan to bring home to adopt in your practice to thrive in practice, despite circumstances and the current pandemic.

This CMA webinar is free to members and nonmembers at: Link to Webinar registration

Operative report copies to the Primary Care Physician (PCP)

It is increasingly common for PCPs to not receive a copy of the Surgeon’s operative report on patients referred to the surgeon.  The copy of the operative report was routine in the past. The absence of an op report affects patient care in a number of ways:

• Patient quality and safety – prevent delay and uncoordinated care.
• Patient confidence in physician communication when the op report is present

Please copy the PCPs on all of the Operative Reports.

Final Thoughts 

“Experience is simply the name we give our mistakes.”
– Oscar Wilde

Keep the faith,