for many of the improvements and successes at CPMC, because physicians have decided where moneys should be spent. A major investment facing St. Luke’s at this time is replacling the emergency department, which is overcrowded and underequipped for the volume of patients seen there. Marc Snyder, current Chair of the department and ER director for many years, has been closely involved in the planning and looks forward to completion in 2007. We regret the retirement of Mary Fedak, Medical Staff Coordinator, November 30. For four years she brought order out of chaos in an increasingly complex operation. Our Director of Performance Improvement, Judy Newman, has taken over Mary’s office and will attempt to manage both roles with adequate clerical assistance. I’m counting on her.
tion survey. This survey has an excellent response rate and has been administered biannually for the past seven years. Such diverse areas such as spirituality, feeling valued, retention and health and safety issues are monitored. This information is shared with the medical staff, administration and the board and is used in for strategic planning and process improvement. It is just one of many reasons our turnover rate is exceedingly low.St. Mary’s submits a Mission Report and a report of its charity care each month to Catholic Healthcare West. It’s this mission and values driven approach to healthcare while commanding clinical excellence and stewardship of our resources that moves us forward.
Veteran’s Diana Nicoll, MD, PHD, MPA
St. Mary’s Kenneth Mills, MD
Excellence is one of the five core values of St. Mary’s Medical Center and clinical excellence is the expectation especially of the medical staff. Peer review is the mainstay of monitoring our quality, measuring our success and finding ways to continuously improve. Peer review is a requirement of the Joint Commission, CMS, IMQ and other regulatory agencies and is carried out in Ssome fashion at every hospital. But peer review itself, as a discipline i undergoing evolution and change. To that end, Catholic Healthcare West has engaged the Greeley Company to assist St. Mary’s and all its facilities to look at what currently is being done and than challenge the institution to improve the process to reflect the need for more practitioner specific information and to apply more sophisticated tools to measure our successes, opportunities for improvement and to identify issues of immediate risk and patient safety.This will be a collaborative venture between medical staff and the community board that have been delegated authority for credentialing and maintaining quality at the medical center.Developing Organizational Capacity (DOC) is the tool that St. Mary’s uses for its employee satisfaction and values integraWWW.SFMS.ORG
The San Francisco VA Medical Center (SFVAMC) opened a newly remodeled and relocated outpatient clinic at Third and Harrison Streets in January 2006 called the VA Downtown Clinic. The new site is near Moscone Center and offers a wide range of clinical and social services to homeless veterans, as it did when the clinic was located at 13th and Mission. To serve the health care needs of veterans in the downtown San Francisco area, the clinic now offers expanded primary care. Veterans in the area may schedule appointments to see a primary care provider and eliminate the commute to SFVAMC, located on the western edge of the City. The VA Downtown Clinic is officially designated by VA as a Comprehensive Homeless Veterans Center where veterans are offered mental health care, substance abuse services, and post traumatic stress disorder treatment targeted for the homeless. It also provides compensated work therapy for homeless veterans to help them gain the skills and habits for employment. SFVAMC geriatric researchers, Sei Lee, M.D., and Kenneth E. Covinsky, M.D. M.P.H., conducted a study to predict mortality among older adults. The study, entitled “Development and Validation of a Prognostic Index for 4-Year Mortality in Older Adults,” was published in the February 15, 2006 issue of JAMA. Dr. Lee and his colleagues developed a 12-question index
that accurately predicts the likelihood of death within four years among people 50 and older. The index, based on a simple point system, is easy to use and can be obtained in a few minutes with an interview or an intake form. For patients and caregivers, predicting near-term likelihood of death is useful when making decisions about medical tests and clinical care.
Seton Stephen Conrad, MD
Although we work in Daly City, our cardiologists are fond of singing that we ‘Left Our Hearts In San Francisco.’ Seton recently celebrated the 40th anniversary of its migration from San Francisco to the sand dunes of Daly City. The move in 1966 was necessitated by patient overflow, limited prospects for expansion, and the new seismic regulations of the 1950s. Sound familiar? As you are aware, annual mammography is now recommended for all women over the age of 40. The Seton Breast Health Center now has a CAD (Computer Aided Detection) system, which scans mammograms and assists the radiologist with the identification of malignancies. If the lesion is suspicious, a minimally invasive Stereotactic Breast Biopsy can be performed. These new devices have reduced the need for open biopsy. Our GI Department has acquired an Endoscopic Ultrasound (EUS) device. This apparatus consists of an ultrasound processor, which is located at the tip of the endoscope and will allow detailed imaging of GI lesions. (What will they think of next?) Seton now has a PET/CT Scanner. The marriage of CT technology and PET technology allows for localization of lesions with greater accuracy. Our medical staff is alive, well, and even flourishing. On 28 April 06, we will hold a historic event---the first annual Physicians Recognition Dinner for the members of the Active Medical Staff. During this festive evening, awards will be given for length of membership and lifetime achievement. The good sisters intend to give a Values Award. Music will provided by the Anton Schwartz Jazz Quartet.
MARCH/APRIL 2006 SAN FRANCISCO MEDICINE
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