I S S U E

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MONTHLY

MEDICAL

STAFF

NEWSLETTER ProgressNotesVOLUME 9

Medical Executive Committee Approvals

In This Issue

Medical Executive Committee Approvals……………………….…..P 1 Infection Prevention and You…….P 2-3 Very Important Clinical Update…..P 4-7 Cardiology Update 2018.….…...…P 8 Holiday Festival……………..……..P 9 Medical Staff Calendar....….…......P 10 New Practitioners………….…...….P 11 Physician/AHP Roster Updates.....P 12

D E C E M B E R 2 0 1 7

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Items approved at the last Medical Executive Committee meeting can be viewed by using this website link and selecting the particular month: http://www.torrancememorial.org/For_Physicians/Medical_Staff/MEC_Approval.aspx . If you have any questions, please contact the Medical Staff Services Department at (310) 517-4616.

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Infection Prevention and You

Methicillin-Resistant Staphylococcus aureus (MRSA)

Key Points

By California Law Primary Care Physicians are responsible for notification of a NEW MRSA diagnosis and educating patients and their families.

Approaches to Prevention of MRSA Transmission

Comply with hand hygiene, “Foam-in, Foam-out” of patient space/room. Follow “Contact Precautions” for patients with ACTIVE MRSA infections. Clean equipment with disinfectant wipes.

Clostridium difficile (C.difficile)

Key Points

C. difficile now rivals MRSA as the most common organism to cause healthcare associated infections in the US, more than doubling its incidence between 2000 and 2009.

C. difficile infection (CDI) increases hospital length of stay by 2.8-5.5 days. In studies over the past 10 years, fluoroquinolones, previously infrequently associated with CDI, have been

found to be primary precipitating antimicrobials. Cephalosporins, ampicillin, and clindamycin remain important predisposing antibiotics. Basic practices for prevention of CDI include appropriate use of antimicrobials, contact precautions for infected

patients, proper cleaning and disinfection, and patient education about CDI. Patients without signs or symptoms of CDI should NOT be tested for C. Difficile.

Influenza

Key Points

Ensure that your patients receive influenza vaccines. Influenza takes a considerable toll on the public’s health each year, causing hundreds of thousands of hospitalizations and thousands of deaths.

The Advisory Committee on Immunization Practices (ACIP) and CDC continue to recommend annual influenza vaccination with an injectable influenza vaccine for everyone 6 months and older, including pregnant women.

The recommendation not to use live attenuated influenza vaccine (LAIV) was extended for the 2017–2018 season.

Optimally, vaccinations should occur before onset of influenza activity in the community. Vaccination efforts should continue throughout the season because the duration of the influenza season varies.

Full recommendations for the 2017–2018 influenza season are online at https://www.cdc.gov/mmwr/indrr_2017.html

Surgical Site Infections (SSI)

Key Points

SSI is now the most common and most costly hospital-acquired infection. Up to 60 % of SSIs have been estimated to be preventable by using evidence-based guidelines.

Basic Practices for Preventing SSI

Administer antimicrobial prophylaxis according to evidence based standards. Do not routinely use vancomycin for antimicrobial prophylaxis.

Control blood glucose during the immediate postoperative period. Educate patients and their families about SSI prevention as appropriate.

Continued on next page….

….continued from previous page

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Catheter- Associated Urinary Tract Infections (CAUTI)

Key Points

Urinary tract infections (UTI) is one of the most common hospital acquired infections’ 70%-80% of these infections are attributable to an indwelling urethral catheter.

Approaches for Preventing CAUTI

Document the necessity for the indwelling catheter DAILY. Identify and remove indwelling urethral catheters that are no longer necessary. The use of indwelling urinary catheter (IUC) shall be limited to patients with:

1. Chronic history of indwelling catheter (present on arrival) 2. Neurogenic bladder (documented in medical record) 3. Actively titrating vasoactive medications (e.g., epinephrine, norepinephrine, phenylephrine) 4. Stage III, IV or unstageable sacral pressure ulcer and incontinence 5. Acute urinary retention or obstruction (after completing use of the Bladder Protocol) 6. End of life care to improve comfort 7. Inserted by urologist, undergoing urologic surgery 8. Obstetric regional anesthesia for labor or cesarean section 9. Patient requires complete immobilization (e.g., Balloon pump, LVAD, receiving paralytic) 10. Immobilized pre-surgery with trauma or fractures preventing turning and placement on bedpan 11. Burn Unit Only: Wounds or skin-grafts prevent turning and placement on bedpan 12. Bladder irrigation

Order the “Bladder Protocol” for the initial management of patients with urinary retention.

1. If the bladder volume > 300ML, perform straight catheterization 2. Repeat scan & straight catheterize every 6 hours 3. If the patient is unable to void after 4 catheterization, notify the physician

Central Line-Associated Bloodstream Infections (CLABSI) Key Points

The risk of central line-associated bloodstream infections in intensive care unit (ICU) patient is high. However, the majority of CLABSIs occur in patients in hospital units outside of the ICU.

Central line-associated bloodstream infections independently increase hospital costs and length of stay 2-5 days.

Approaches to Prevention of CLABSI

Document the necessity for the central line DAILY. Promptly remove any central line that is no longer essential.

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Very Important Clinical Update

5

Very Important Clinical Update

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Very Important Clinical Update

7

Very Important Clinical Update

Cardiology Update 2018

CARDIOLOGY UPDATE 2018 CONVENTIONAL WISDOM AND BEYOND

For physicians & healthcare professionals only

NEW TOPICS

Mitral Valve Surgery Marc Gillinov, M.D.

Mitral Valve Regurgitation: Percutaneous Options

Salman Azam M.D. & Chris Matchison, M.D.

Management of Cardiogenic Shock: Role of ECMO & TCS Jaime Moriguchi, M.D., FACC

Lipid Management Karol Watson, M.D., FACC

Percutaneous Revascularization of Coronary Chronic Total Occlusions

Michael Wyman, M.D.

Update on Diabetes Care Cynthia Williams, M.D.

The Heart Failure with Normal Ejection Fraction Conundrum Thomas Heywood, M.D., FACC

Treatment of Aortic Stenosis Paul Teirstein, M.D., FACC

American Health Care Marketplace James Field, MBA, DBA

Update on Cardiac Imaging Gaurav Banka, M.D.

Heart Failure Management Michele Hamilton, M.D., FACC

Treatment of Cardiac Arrhythmias Michael Shehata, M.D., FACC

Advances in Stroke Treatment Shlee Song, M.D.

Palliative Care in Heart Failure Eric Adler, M.D.

Exercise-Related Collapse in Athletes - Not Always the Heart

Paul Thompson, M.D.

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Friday April 20, 2018 8:00 a.m. - 5:00 p.m.

For more information call (310) 517-4720 or visit our website at http://www.torrancememorial.org/cardiosymposium

Festiv

al Tre

es

for P

re-Sa

le

Nov

. 28 -

Nov

. 30

Public Exhibit & Boutique Shopping

Special Events - Reservations Required

Tuesday, November 28.…………………….…………………………………………....………...1:30 - 3:30 p.m.

Wednesday, November 29..……………………………………………………...………………...10 a.m. - 9 p.m.

“Senior Day #1” - Free admission for seniors & those with special needs...…………...10 a.m. - 2 p.m.

Thursday, November 30…………………………………………………………………..………..10 a.m. - 9 p.m.

“Senior Day #2” - Free admission for seniors & those with special needs…....………...10 a.m. - 2 p.m.

Non-Profit & Community Service Group Night - Special Rate of $2 for admission...….. 4 p.m. - 9 p.m.

Friday, December 1 - CLOSED TO THE PUBLIC

Saturday, December 2………………………………………………………………...…………...10 a.m. - 9 p.m.

Sunday, December 3………………………………………………………………...……………..10 a.m. - 4 p.m.

$5 General Admission - Children age 5 and under are free.

Enjoy beautifully decorated holiday trees, boutique, food court and local entertainment.

NOVEMBER 28 - DECEMBER 3, 2017 Located in the white tent at Medical Center Drive and Skypark Drive.

34th Annual

Donated by Toyoto Motor Sales, USA, Inc. Call 310-517-4703 to buy

opportunity drawing tickets.

Win a Lexus! Grand Prize

2017 Lexus RX 450h

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3330 Lomita Blvd., Torrance, CA 90505 . www.TorranceMemorial.org/HolidayFestival . 310-517-4606 9

Festival Fashion Show - $125 per person - Tuesday, November 28, 9:30 a.m. - 3:30 p.m.

Festival Night Dinner Gala - $300/person, $550/couple - Friday, December 1, 5:30 p.m. - 10:30 p.m.

Lunch with Santa - $15 per person - Sunday, December 3, 11 a.m. - 1 p.m.

Monday Tuesday Wednesday Thursday Friday

1 7:00a Lung TumorBoard..WT-Aud 7:00a Surgery Dept…….…..WT-C 7:30a IRB…………….……..WT-D

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5 12:30p Donor & Transfusion…..WT-C

6 7:00a CV Review Conf……….WT-D

7 7:00a Breast Tumor Board..WT-Aud 7:45a Gen Tumor Board…..WT-Aud 12:30p Medical Staff PI……..….WT-D

8 7:00a Lung TumorBoard..WT-Aud

11 12:30p Credentials………......WT-C

12 5:00p Quality & Patient Safety Committee……..…..…..WT-C 6:00p Medical Executive……..WT-D

13 7:00a Anesthesia PI….… ..WT-Aud 7:00a CV Review Conf……….WT-D

14 7:00a Breast Tumor Board..WT-Aud 7:45a GI Tumor Board….....WT-Aud

15 7:00a Lung TumorBoard..WT-Aud

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19

20 7:00a CV Review Conf……….WT-D

21 7:00a Breast Tumor Board..WT-Aud 7:45a CNS Tumor Board….WT-Aud

22 7:00a Lung TumorBoard..WT-Aud

25

26

27 7:00a CV Review Conf……….WT-D

28 7:00a Breast Tumor Board..WT-Aud 7:45a GI Tumor Board….....WT-Aud 12:30p Credentials……….….....WT-C

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CME CONFERENCES

Wednesdays, 12:30 p.m. Hoffman Health Conference Center

Torrance Memorial Medical Center is accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA) to provide continuing medical education for physicians.

Torrance Memorial Medical Center designates this live activity for a maximum of 1 AMA PRA Category I CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. For up-to-the-minute conference information call (310) 784-8776 or visit: http://www.torrancememorial.org/For_Physicians/Wednesday_CME_Conferences.aspx

Medical Staff Calendar December 2017

December 13, 2017 NO CONFERENCE

December 20, 2017 NO CONFERENCE

December 6, 2017 NO CONFERENCE

December 27, 2017 NO CONFERENCE

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January 3, 2018 “Advances in Stroke Care” Asma Moheet, M.D. Cedars-Sinai Medical Center Commercial Support: None

January 17, 2018 NO CONFERENCE

January 24, 2018 NO CONFERENCE

January 10, 2018 “Hospital Acquired Infections” Paul Holtom, M.D. USC School of Medicine Commercial Support: None

January 31, 2018 NO CONFERENCE

Welcome New Practitioners

Deborah A. Chon, M.D. Medicine UCLA Health Southbay Endocrine, Thyroid & Diabetes Center 3445 Pacific Coast Hwy., Ste. 100 Torrance, CA 90505 Phone: (310) 542-6333 Fax: (310) 326-2236

Faysal G. Saab, M.D. Medicine UCLA Health Santa Monica Hospitalists 1250 16th St., Ste. C2304 Santa Monica, CA 90404 Phone: (310) 319-4698 Fax: (310) 206-3260

Kelly A. Enright, D.O. Medicine HealthCare Partners Hospitalists 3330 Lomita Blvd., HCP 1st Floor Torrance, CA 90505 Phone: (310) 214-0811 Fax: (310) 784-4991

Melissa L. Wang, M.D. Medicine UCLA Rheumatology 3500 Lomita Blvd., Ste. 302 Torrance, CA 90505 Phone: (310) 257-0129 Fax: (310) 257-0130

Sindalana Hean, M.D. Medicine HealthCare Partners Hospitalists 3330 Lomita Blvd., HCP 1st Floor Torrance, CA 90505 Phone: (310) 214-0811 Fax: (310) 784-4991

Emily Huang, M.D. Medicine UCLA Health Santa Monica Hospitalists 1250 16th St., Ste. C2304 Santa Monica, CA 90404 Phone: (310) 319-4698 Fax: (310) 206-3260

Samir Kapadia, M.D. Medicine South Bay Gastroenterology Medical Group 23600 Telo Ave., Ste. 260 Torrance, CA 90505 Phone: (310) 539-2055 Fax: (310) 539-0199

Megan R. Linnebur, M.D. Surgery Association of South Bay Surgeons 23451 Madison St., Ste. 340 Torrance, CA 90505 Phone: (310) 373-6864 Fax: (310) 373-9547

David J. Liss, D.P.M. Surgery 9100 S. Sepulveda Blvd., Ste. 100 Los Angeles, CA 90045 Phone: (310) 645-3338 Fax: (310) 645-0823

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Address Change Catherine E. Bannerman, M.D. Family Practice contact Medical Staff Office Jashdeep S. Dhoot, M.D. Medicine Providence Medical Associates - Torrance 21311 Madrona Ave., Ste. 101 Torrance, CA 90503 Phone: (310) 370-3568 Fax: (310) 792-4093 Jennifer W. Hsu, M.D. Surgery Orthopaedic Institute 19000 Hawthorne Blvd., Ste. 100 Torrance, CA 90503 Phone: (310) 542-3472 Fax: (310) 542-2569 Naoko Matsumoto, M.D. Pediatrics Naoko Matsumoto, M.D., Inc. 3440 Lomita Blvd., Ste. 321 Torrance, CA 90505 Phone: (310) 483-7880 Fax: (310) 564-2356

Phone/Fax Change Maxwell A. Dartey, M.D. OB/GYN Fax: (310) 935-7888 Sharon E. Campbell, M.D. Pediatrics Phone: (310) 370-9031 Fax: (310) 214-9745 Suite Number Change Linda Brown, M.D. Pediatrics Ste. 201 Sharon E. Campbell, M.D. Pediatrics Ste. 201 Judy A. Hunter, M.D. Pediatrics Ste. 201 Ananta Malla, M.D. Pediatrics Ste. 201 Erica A. Veeh, M.D. Pediatrics Ste. 201

Leave of Absence Anthony G. Leung, M.D. Surgery Akshay M. Mehta, M.D. Surgery Carl N. Muchnick, M.D. Pediatrics Arthur L. Wisot, M.D. OB/GYN Resignation Gretchen J. Andersen, P.A. Surgery Willie B. Boone, M.D. Surgery Chang W. Rhee, M.D. Anesthesiology David Q. Shih, M.D. Medicine Retired David A. Berstein, D.P.M. Surgery

The Medical Staff Newsletter ProgressNotes is published monthly for the Medical Staff of Torrance Memorial Medical Center. Vinh Cam, M.D. Chief of Staff Robin S. Camrin, CPMSM, CPCS Vice President, Medical Staff Services & Performance Improvement A.Klecker-12/2017

Physician/AHP Roster Updates

12

ProgressNotes Vol. 9 Issue 12 December 2017

ProgressNotesMONTHLY

MEDICAL

STAFF

NEWSLETTER

Medical Staff Services 3330 Lomita Boulevard Torrance, CA 90505 Phone: (310) 517-4616 Fax: (310) 784-8777 www.TorranceMemorial.org

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