INNOVATIONS SECOND EDITION
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Here at Riverside University Health System – Medical Center, every member of our staff aims to provide both exceptional and compassionate care to the community we serve. Ensuring the environment, technology and even location compliments the care we give. When we first thought of expanding upon the services we provide, our top priority was making sure patients had access to an integrated quality healthcare system to support their medical needs. The Medical and Surgical Center (MSC) is a critical piece of the care continuum. The MSC expanded patient care capacity, allowing RUHS to provide the right care, at the right time, in the right setting. The three-floor state-of-the art building houses a wide range of departments from women’s health, pediatrics, surgery, internal medicine and even cancer care just to name a few. The completion of the building in March 2020 came at a vital time that allowed us to expand the care and services provided to patients during this unprecedented time. The features of the building along with the additional space, allowed our teams to modify patient units in order to expand our capacity within the main hospital to care for more critically ill patients in our region. Beyond the pandemic, it is our hope that we will continue to expand upon the healthcare services and resources needed in order to provide our patients the very best in care that they deserve. We hope that from the moment you step foot on our campus that you feel you belong. Because you do. We deeply care about you and the patients we serve. Our team of talented and skilled staff will continue to strive to make sure that RUHS continues to innovate and raise the bar on the services provided to those that entrust their healthcare needs to us. I hope that this edition of the Innovations Magazine that spotlights our new MSC will serve as comfort that you have invested in the best opportunity for top care. Sincerely, Jennifer Cruikshank, CEO Riverside University Health System Medical Center and Community Health Centers
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CONTENTS
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FLOOR MAP MEDICAL AND SURGICAL CENTER | INTERIOR
Access to services is greatly improved with the opening of the Medical and Surgical Center at Riverside University Health System - Medical Center. On the first floor, a convenient retail pharmacy is centrally located between both entrances to the building across from a Panera Bread Grab N Go location. Physical therapy and rehabilitation departments have been greatly expanded and can now offer state-of-the-art gym equipment. Imaging and Diagnostics are also present, allowing patients easier access to these services. The second floor is dedicated to the various wings of our surgery department. The proximal locations allow our surgeons to see more patients and provide more effective care. On the 3rd floor our Main Campus Community Health Center lives, providing specialized care to Pediatrics, Women’s Health and Internal Medicine patients.
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Floor 3
Main Campus Community Health Center
• Internal Medicine Clinic - Rheumatology - Endocrinology - Diabetes Clinic - Infectious Disease -Cardiology
• Pediatrics Clinic - Infectious Disease - Allergy/pulmonolgy - Behavioral Health - Cardiology - Endocrinology - Gastrointestinal • Women’s Health Clinic - High-Risk Infant - Oncology - Nephrology - Urogynecology - Neurology - Maternal Fetal Medicine - Obesity • Family Care Clinic
• General Surgery Clinic -Vascular Surgery • Surgical Specialties Clinic - Colorectal Cancer Services - Breast Cancer Services • Orthopedics and Spine Clinics • Pre-Operative Services and Post-Anesthesia Care Unit (PACU) • Outpatient Surgery -Pre-Anesthesia Testing
Floor 1
• PT/Rehabilitation (Outpatient) -Pediatric • Imaging (Outpatient) • Diagnostics (Outpatient) • Pharmacy (Retail) • Lab (Outpatient) • Registration • Panera Bread Grab & Go • Family Care 3
Family Care Clinic
Pediatrics
Surgery Clinic
Floor 2
Women’s Health
Internal Medicine
Post-Anesthesia Care Unit (PACU)
Pre-Operative Services
Orthopedics and Spine Clinics
Outpatient Surgery
Parking Lot E Outpatient Diagnostics
Physical Therapy /Rehabilitation Gym
Lab Services
Family Care 3 Parking Lot C
Parking Lot D
Entrance/Exit
Restrooms
Waiting Area
Panera Bread Grab & Go
Elevators
Stairway
Pharmacy
Registration Desk - Women’s Health - Floor 3
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FIRST 6
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FLOOR On this floor: Physical Therapy/Rehabilitation Pediatric Imaging (Outpatient) Diagnostics (Outpatient) Pharmacy (Retail) Lab (Outpatient) Registration Panera Bread Grab & Go Family Care 3
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Convenient Panera Bread Grab N’ Go
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“To minimize wait times, we offer mail order delivery of maintenance medications.” - Edward Yen, PharmD
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PHARMACY DEPARTMENT | FIRST FLOOR LOBBY
The MSC pharmacy was established with patient safety, convenience, and customer service as its top objectives. To ensure safe interactions, this is now the only retail pharmacy location available for walk-up service on the RUHS Medical Center campus. In addition to all staff and patients wearing surgical masks, the pharmacy also has physically distanced lines to drop-off and pick-up prescriptions with sneeze guards at each station.
prior authorization needs you may encounter. In addition to competitive prescription costs, the pharmacy also offers a variety of over-thecounter products offered at very competitive prices for the convenience of both patients and employees. To minimize wait times, we offer mail order delivery of maintenance medications. Please don’t hesitate to stop by if there is anything our friendly staff can assist you with.
A large notice board displays when a prescription is ready, alerting patients when to make their way back to the counter to get their medication. Our clinical pharmacy specialists work with our patients and their physicians to optimize the appropriate pharmacotherapy options by taking into consideration all of the patient’s needs. Our pharmacy has direct access to the health system’s electronic medical record platform (EPIC) to facilitate efficient and accurate communication of care plans. Most major insurances are accepted and we will work with your physician to expedite any
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ruhealth.org/services/pharmacy
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PHYSICAL THERAPY REHABILITATIVE SERVICES DEPARTMENT | FIRST FLOOR
Physical therapy includes diagnosis and management of movement dysfunction and enhancement of physical and functional abilities; restoration, maintenance, and promotion of optimal physical function, optimal fitness and wellness, and optimal quality of life as it relates to movement and health; and prevention of the onset, symptoms, and progression of impairment, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries. Physical therapists are healthcare professionals who maintain, restore, and improve movement, activity, and health enabling an individual to have optimal functioning and quality of life, while ensuring patient safety and applying evidence to provide efficient and effective care. Physical therapists evaluate, diagnose, and manage individuals of all ages who have impairments, activity limitations, and participation restrictions. In addition, physical therapists are involved in promoting health, wellness, and fitness through risk factor identification and the implementation of services to reduce risk, slow the progression of or prevent functional decline and disability, and enhance participation in life situations. In addition to providing habilitation and rehabilitation services, as well as prevention and risk reduction services, physical therapists also collaborate with other healthcare professionals to address patient needs, increase communication, and provide efficient and effective care. Physical therapists also provide consulting, education, research, and administration services across the continuum of healthcare settings. Our new facility is a state-of-the-art 10,000 square foot rehab gym that includes cardiopulmonary rehab with full telemetry, wound care, dedicated indoor and outdoor pediatric treatment spaces and seven fully private treatment rooms. Our rehabilitative services department features a new pelvic physical therapy program and also includes occupational therapy, speech therapy and wound care services.
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“Our new facility is a stateof-the-art 10,000 square foot rehab gym that includes cardiopulmonary rehab on full telemetry.” Photograph taken prior to the COVID-19 pandemic. RUHS recommends following masking guidelines. RUHS INNOVATIONS
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- Yohann Injety, RUHS Physical Therapist
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IMAGING AND DIAGNOSTICS DEPARTMENT | FIRST FLOOR
Our imaging and diagnostic capabilities at RUHS have greatly increased with the addition of our state-of-the-art molecular breast imaging camera and a new PET/CT scanner. The molecular breast imaging camera on our first floor is one of only a handful of units in operation across the nation. Coupled with the dual head camera, which can perform a biopsy, this new technology adds a new dimension for high-risk patients with dense breasts and reports fewer false positives than traditional MRI scans.
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A brand-new PET/CT scanner was gifted by a confidential donor this past year. While the imaging machine itself is not unique, it is a completely new service for us here at RUHS Medical Center and allows us to perform inpatient services. We did 37 PET scans in June and 42 scans in July. Our oncology patients now have a one-stop-shop that allows them to get all their imaging done in one central location with improved consistency between reports, the ability to compare results quickly, and ready access for oncologists to discuss with radiology and facilitate presenting their patients at our tumor board. Over 2,700 imaging exams were performed in July alone, even before we made our ultrasound appointments available. We also take walk-in X-rays and can accommodate same-day mammograms for RUHS patients.
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FLOOR On this floor: General Surgery Clinic Vascular Surgery Specialty Surgical Clinics Orthopedics and Spine Clinics Pre-Operative Services and Post-Anesthesia Care Unit (PACU) Outpatient Surgery Pre-Anesthesia Testing Self Check-In Kiosks (Available on all floors)
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Photograph taken prior to the COVID-19 pandemic. RUHS recommends following masking guidelines. 16
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SURGICAL CENTER DEPARTMENT | SECOND FLOOR
A new, conveniently located, spacious Outpatient Surgical Center (OSC) has opened in the recently constructed Medical and Surgical Center (MSC) on the RUHS Medical Center campus in Moreno Valley. The OSC services include General, Orthopedic, Gynecological, ENT, Plastics, Ophthalmology, Urology, Vascular, and Pediatric surgeries. Patients are admitted and prepared for surgery by dedicated, friendly, and experienced staff in specially designed intake rooms adjacent to the state-of-the-art surgical suites. The OSC has been outfitted with industry leading equipment innovatively installed to allow safe and efficient operating times and availabilities. There are eight operating suites, 28 pre-operation/ post-anesthesia care beds and three expansive procedural rooms. All rooms are large, well lit and fully equipped with integrated technology, such as innovative anesthesia monitoring and ergonomically designed operating tables. The OSC is fully vested with outpatient surgical equipment specifically designed for minimally invasive surgery, both laparoscopic and hysteroscopic, with the latest in air and fluid management systems for the ultimate in comfort and safety. Post-operative recovery is immediately adjacent to the operating rooms, where patients can recover and be discharged to their support persons for ease of transition to available transportation.
The Outpatient Surgery Center presented a unique opportunity with spacious pre and post anesthesia bays complete with medical gas, bathrooms and operating rooms that could be used as designated delivery rooms. The department was able to separate COVID-19 and non-COVID-19 patient care areas and set up the NICU in close proximity for immediate transfer and care of preterm infants. We extended our fetal monitoring support structure to the new building to ensure the secure and efficient delivery of care to our maternal and neonatal population while giving the main hospital an increase of approximately 32 critically needed beds.
Surgical Specialties In addition to the Outpatient Surgical Center, the second floor is home to a host of surgical specialties and ammenities including: • • • • • • •
General Surgery Department Orthopedics and Spine Clinic Colorectal Cancer Specialty Services Breast Cancer Specialty Services Post-Operative Services Post-Anesthesia Care Unit Pre-Admission Testing
With the fall surge of COVID hospital admissions, the administration was in search of more ICU capacity and the decision was made to transfer the Labor and Delivery Unit along with the NICU to the second floor of the MSC. RUHS INNOVATIONS
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THIRD Photograph taken prior to the COVID-19 pandemic. RUHS recommends following masking guidelines. 18
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FLOOR On this floor: Internal Medicine Clinic Rheumatology Endocrinology Diabetes Clinic Infectious Disease Cardiology Women’s Health Clinic Oncology Urogynecology Maternal Fetal Medicine
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Pediatrics Clinic Infectious Disease Allergy/Pulmonology Endocrinology Gastrointestinal High-risk Nephrology Neurology Surgery Family Care Clinic
Main Campus Community Health Center
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WOMEN’S HEALTH DEPARTMENT | THIRD FLOOR
“A fully licensed Prenatal Diagnostic Center is available for counseling patients with chromosomal anomalies, abnormal fetal testing and genetic diseases.” - Dr. Ronald Johnson
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The Women’s Health Center was built on the concept of comprehensive care in a culture of excellence spanning a woman’s lifetime. From entry into the third-floor lobby through a visit in the expansive center gives a view of a modern, light infused experience. Three nursing pods are home to multiple comprehensive women’s services anchored by Maternal Fetal Medicine with a focus on women who are at high risk with complicated pregnancies. A full time Perinatalogist oversees care with on-site behavioral and nutritional support including Sweet Success diabetic counseling and management. Support services are available for women with substance abuse disorders. A fully licensed Prenatal Diagnostic Center is available for counseling patients with chromosomal anomalies, abnormal fetal testing and genetic diseases. There is an imaging center with state-of-the-art ultrasound technology to detect fetal anomalies and monitor all pregnancies. A proceduralist
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is available for diagnostic testing with a reading room for remote ultrasound and telehealth consult service covering all areas of Riverside County. A welcoming nonstress test area is available for monitoring of fetal status in comfortable surroundings and soothing décor. This allows a combination of fetal monitoring with prenatal visits relieving the stress of multiple appointments at diverse locations to accommodate a busy schedule. A full-service obstetrics and gynecology service offers screening exams and follow up of abnormal Pap smears with colposcopy and biopsies, if needed. The center is also equipped with technology for LEEP conization and Cryotherapy of the cervix to treat those with abnormal cytology and histology. A full menu of birth control options and counseling is also available with the service overseen by board certified physicians.
A fellowship trained Uro-Gynecologist offers full spectrum testing for women with bladder and vaginal support issues assisted by instruments for full urodynamic and cystoscopic testing and procedures. Our fellowship trained Gynecologic Oncologist works with women who have a diagnosis of cancer offering minimally invasive and robotic surgical care and coordinating chemotherapy and radiation therapy when needed. An outpatient laboratory can be accessed in the center upon completion of the visit to expedite testing with convenience of location saving time and travel.
ruhealth.org/services/womens-health
Photograph taken prior to the COVID-19 pandemic. RUHS recommends following masking guidelines. RUHS INNOVATIONS
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PEDIATRICS DEPARTMENT | THIRD FLOOR Immediately upon entering the space dedicated to pediatric care at the MSC you will notice the art and décor generously gifted by the John P. Previti Memorial Foundation. The ambience created through the décor furthers the mission of our department in improving the health and well-being of children and their communities. Beyond décor, the pediatrics department has the ability to provide care for the comprehensive spectrum of children that need it.
Services Available Along with full scope general pediatrics care, our clinic provides specialty care in pediatric cardiology, endocrinology, infectious disease, allergy and immunology, nephrology, neurology, gastroenterology and pediatric surgery. We also provide a clinic focused on healthy living for children with obesity or with risk factors for obesity. Additionally the high-risk infant clinic provides care for premature infants that have graduated from the NICU to continue to track their growth and development. Pediatricians see about 700 to 800 patients per month or 9,000 per year.
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The pediatric clinic is also a continuity clinic for the collaboration between RUHS and Loma Linda University Pediatric Residency Primary Care Track.
HealthySteps Through a partnership with First 5 Riverside, RUHS has implemented HealthySteps — a national program aimed at improving screening for developmental, behavioral or social determinant of health concerns to improve the health and wellbeing of children with an emphasis on children from low-income families. A HealthySteps Specialist is able to assist with the implementation of the screenings and also help with potential problems that are identified through the screening tools. This has been immensely helpful to our physicians and the families that we serve.
Local Dental Pilot Project In another collaboration with First 5 Riverside, the Pediatric Clinic has staff to address the dental needs of our patients. Children under 5 receive dental screenings, fluoride varnishes and a goody SECOND EDITION
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bag of educational materials and age appropriate toothbrushes. Part of the mission of the program is to ensure scheduled follow-ups with a dentist in their area once they receive a screening at our clinic. This helps ensure that children get the dental care to prevent cavities and other dental problems.
Patient Visits During the Pandemic Thanks to the use of MyChart, our electronic health patient portal, we’ve had more options in how we see patients during the COVID-19 pandemic. This technology has allowed pediatricians to perform video visits through MyChart for visit types that do not require an in-person evaluation and decreased the risk for families and our staff. It also gives parents a lot more access and capabilities related to their child’s health as they are able to send messages to the healthcare team, schedule appointments and review records through MyChart. The RUHS pediatric staff has also implemented the Welcome module which allows parents to electronically fill out forms upon arrival to the clinic if they do not have MyChart access or did not fill them out ahead of time.
ruhealth.org/services/childrens-health
FAMILY CARE CLINIC DEPARTMENT | THIRD FLOOR
Our newest Community Health Center lives on the third floor of the Medical and Surgical Center at our Medical Center campus in Moreno Valley. At the Main Campus Community Health Center we are able to distribute COVID-19 vaccines for our community members across Riverside County. RUHS INNOVATIONS
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With behavioral health integration now a part of our services on the third floor, it allows our medical teams to continue to champion whole person health, because health is more than just physical. Visit the Main Campus Community Health Center and receive your Whole Person Health Score. 23
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INTERNAL MEDICINE DEPARTMENT | THIRD FLOOR
The Internal Medicine clinic, located on the third floor of the MSC, welcomes you to a spacious, peaceful, sunlit waiting room offering sweeping views of the surrounding hills. The MSC clinic rooms are outfitted with state-of-the art equipment and technology to help RUHS provide efficient, top-notch care. The clinic is anchored by board certified internal medicine providers who offer comprehensive primary care services for acute and chronic diseases, anticoagulation management and preventative care. The RUHS Internal Medicine team is unique. It serves as a teaching site for two fully accredited Internal Medicine residency programs. There are 34 residents who train in our clinic for the duration of their 3-year program. RUHS has a goal to provide ongoing mentorship and guide residents in their professional development.
treatment related procedures. Specialty fellowship training programs are integrated into the cardiology and rheumatology clinics. The Internal Medicine department has specialists trained in behavioral health, nutrition, clinical pharmacology, case management and health coaching integrated into the care model at the MSC to help provide individualized supportive care. The RUHS staff is committed to providing comprehensive, compassionate care to all patients.
Internal Medicine subspecialty services are rendered by board certified providers in cardiology, endocrinology, diabetes, infectious disease and rheumatology. Cardiology has expertise in managing patients with congestive heart failure, ischemic and valvular diseases and other cardiac conditions. They also offer advanced diagnostic services at the MSC. The diabetes clinic offers a comprehensive multispecialty program which includes personalized teaching and training. The infectious disease team provides comprehensive care for patients living with HIV and consultative care for complex infectious diseases. Rheumatology providers care for patients presenting with a broad range of autoimmune and inflammatory diseases. They utilize bedside ultrasound to aid in diagnosis and
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INFECTIOUS DISEASE DEPARTMENT | THIRD FLOOR
COVID-19 Clinical Preparation and Mitigation Group leads MSC safety during COVID-19
In addition, the team created a service flow for positive patients who entered the MSC and how to get them in safely and keep staff members and physicians safe during care.
The COVID-19 Clinical Preparation and Mitigation Group at Riverside University Health System (RUHS) is on the front lines of the COVID-19 pandemic ensuring patient safety to those seeking care at both the Medical Center and MSC. The team’s innovative and rapid response to the creation of on-site COVID-19 testing and safety protocols permitted the MSC to open safely during the pandemic.
Infectious disease specialist Bruce Weng, DO, says that the team worked rapidly, creating a model that would serve patients in need.
Surgeries, necessary in-person physician visits and the overall health and wellness of the Riverside County patient population do not stop because the world is experiencing a pandemic. It is necessary to still offer premier care to patients in need.
The diagnostic group is multidisciplinary, including an infectious disease physician, professor of research, pharmacist, infection prevention and control manager, laboratory leadership and a pathologist.
Navigating commitment and access was a nationwide challenge the RUHS COVID-19 Clinical Preparation and Mitigation Group met immediately. Chief Medical Officer Arnold Tabuenca, MD, spearheaded the specific creation of a COVID-19 diagnostic group. The group’s main premise was to formulate plans and guidance on how to implement testing and safety protocols at RUHS, based on guidance from Centers for Disease Control and Prevention (CDC), state and local regulatory authorities.
This all-inclusive approach not only allowed for a safe opening but also increased testing capacity. In June, the team was able to switch from sending testing to outside facilities to conducting testing on site. This change decreased the result time from up to a week, to same-day results.
“During a global pandemic, patients need care more than ever,” Weng says. “We had to leverage the team’s disciplinary expertise to create precise algorithms for procedures and protocols for employees and staff to feel safe to come in.”
The team has proven that a global pandemic stands no chance against the expertise and wealth of knowledge that RUHS possesses.
The diagnostic group created COVID-19 testing protocols for patients receiving surgery at the MSC. The team also contributed to creating screening measures for all visitors which included the questionnaire that would most appropriately measure a patient’s positivity.
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ANEOUS Photograph taken prior to the COVID-19 pandemic. RUHS recommends following masking guidelines. RUHS INNOVATIONS
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MOBILE TESTING LAB BY ADRIANA ROSATO, MSC; PHD Riverside University Health System - Medical Center opened the innovative Mobile Lab that elevated their level of COVID-19 patient care and paved the way for future innovative treatments for cancer, infectious diseases and genetic diseases. The inception of the modernized Mobile Lab in the Summer of 2020 allowed for rapid COVID-19 testing that helped support staff and patient testing. This ensured continued care at the hospital during these unprecedented times. The institution relied heavily on the Mobile Lab molecular testing to make informed care decisions. Outfitted with both negative and positive pressure capabilities, it yielded gold standard testing. The testing conducted helped determine how many viral particles a patient has and when the disease is starting to resolve. These insights were pivotal in management decisions; for example, infectious disease specialist, Bruce Weng, DO, has been able to rely on the lab’s results to make important decisions, such as when to discharge a patient or deciding to de-isolate a patient. Currently, the mobile lab has been able to expand the current COVID-19 molecular testing to identify the new B1.1.7 COVID-19 mutated UK variant. This initiative will have important patient management and epidemiological implications. Following the COVID-19 pandemic, RUHS expects to transition the Mobile Lab services to collaborate with additional hospitals and communities. The lab will upgrade the molecular testing to other fields such as cancer and genetic diseases, to provide crucial diagnostic, prognostic and therapeutic information to patients and physicians. The plans are to be able
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“Being so involved in the COVID pandemic has been an amazing personal experience” - Dr. Adriana Rosato
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to perform tests on many different types of clinical specimens (blood, body fluids, biopsy tissue, etc.) to detect DNA markers that serve as signatures that help healthcare workers provide optimal care. The lab is overseen by microbiologist and molecular biologist, Adriana Rosato, MSc; PhD, who was the director of a laboratory of clinical and basic research at the Department of Pathology and Infectious Diseases at Houston Methodist Hospital. Her infectious disease experience began in 1998, where she studied Tuberculosis and its resistance to antimicrobials at Children’s Hospital Los Angeles was followed by 23 years of extensive research on Gram positive methicillin resistant S. aureus (MRSA) infections.
Dr. Rosato and Mobile Testing Lab colleague
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Mobile Testing Lab equipment
Lab equipment
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INNOVATIONS PODCAST AND WEBINAR Throughout the pandemic, our team of experts have been sharing best practices with their peers to support response and recovery efforts.
Webinar Series With the current events unfolding at hospitals across the country in response to the COVID-19 pandemic, RUHS continues to share innovations direct from our frontline providers. This webinar occurs monthly. If you are interested in attending the webinar please email us at webinar@ruhealth.org to register for an invite.
Innovations Podcast We are preparing to launch a podcast series where our helpful information and best practices can be more easily shared and recorded. After witnessing the success our webinar series had in providing valuable information about happenings at the hospital we know we can do more to shine the light on important messages.
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INNOVATIONS RIVERSIDE UNIVERSITY HEALTH SYSTEM
DR. EDWARD BACHO Graphic Design HEATHER JACKSON Editor / PIO MURAD KAKISH Layout / Typography CHRISTINE RAMSEY Asst. Marketing Director
RUHS MARKETING 26520 Cactus Avenue Moreno Valley, CA 92555 marketing@ruhealth.org ruhealth.org
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Riverside University Health System - Medical Center 26520 Cactus Avenue Moreno Valley, CA 92555 ruhealth.org
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