St. Vincent Times April 2011

St. V incent Times APRIL 2011

publication of St. Vincent Medical Center

ONE DENIAL AT A TIME ENDANGERING PALLIATIVE CARE

Out of 138 hospitals, US News and World Report ranked St. Vincent Medical Center among 10 Best Hospitals in Greater Los Angeles!

Doctors’ Day Honors and Appreciation Page 3 P

1st hospital in Los Angeles

Cancer Treatment Center Takes Aim at Pain Page 4 P VINCENTIAN VALUES:

Respect

Compassionate Service

Simplicity

Advocacy for the Poor

Inventiveness to Infinity

COVER STORY Patients return to the Cancer Treatment Center to say “thanks” to the team.

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SVMC honors our physicians with a party and grassroots awards ceremony. Associates write thank-you notes to physicians for their responsiveness, excellent patient care, and great teamwork.

Physicians win awards in various categories.

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NURSES LEAD SEPSIS PREVENTION

Spiritual Care Director

As we celebrate success, this is also the time of year that we observe the 40 days of Lent. It is a time of reflection, focusing on our spiritual life and for many of us, a time of fasting, abstinence, “giving up sweets.” All of this is in preparation for the resurrection of Christ and the celebration of Easter. This is also a time for school children to enjoy spring break and a reprieve from the rigors of study.

Nurses develop order sets for early intervention and treatment of sepsis. Meet the members of the CCU CARE Team.

Page 7 St. Vincent Times is a publication for St. Vincent Medical Staff and Associates. Please submit articles as soon as possible prior to or after an event for the earliest inclusion in the newsletter by e-mailing information to SharonGreengold@DOCHS.org or by calling (213) 484-5593. Medical Staff submissions may also be sent to SusanLauzier@DOCHS.org. Or call (213) 484-5525.

For us here at St. Vincent Medical Center, we continue to care for the sick/poor through different programs at the Medical Center.

The Leadership, Excellence, Accountability Program (LEAP) is expanding and many of you are involved in support teams to look at supply and cost reduction with particular focus on linen, dietary, O.R. and supplies. Thanks to all of you for your support in this area. We continue to work with the Medical Staff to develop a Physician Alignment Program that involves a Medical Staff succession plan.

Ronald S. Fishbach, MD – chief of medical staff Cathy Fickes – president/chief executive officer Sr. Sylvia Parks, DC – chairman of the board

As we continue our quest to provide the highest quality of care, we ask that you focus on two basic elements:

got concerns?

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1. Protecting our patients from falls and,

Physicians may report safety or quality of care concerns:

2. Making sure that every person who touches a patient has washed his/her hands. The best way that we can protect our patients while they are in the hospital is by paying attention to these two very sensitive areas. So please join me as we develop our initiatives and focus our efforts in prevention of falls and prevention of infection by handwashing for everyone.SVT

(213) 207-5783.

Call the Values Line at (800) 371-2176 or go online at www.dchsvaluesline.org to report concerns confidentially and anonymously.

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CARE Team CCU

This distinction of being ranked 9th out of 138 hospitals in Greater L.A. is based on our care of adults in Ear, Nose & Throat, Neurology, Cancer treatment, Kidney services, Urology, Orthopaedic Surgery, Pulmonology, and Geriatric services. This is the 3rd consecutive year that SVMC has received awards for outstanding services, great outcomes, and quality patient care.

The quality of our care is vetted by regional and national surveys; heralded by healthcare associations and the media. And the credit goes to our staff and physicians.

DOCTORS’ DAY

physician quality hotline:

T i m e s St. Vincent Medical Center

hank you for making St. Vincent Medical Center one of the Top 10 President/CEO Best Hospitals, according to US News & World Report. This is truly a welcome introduction to spring. We begin to feel that perhaps winter is ending and that summer is around the corner.

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Fr. TOM GRIFFIN, S.J.

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St. Vincent Medical Center

APRIL 2011

CAT H Y F I C K ES

ceo notes

St. Vincent Times

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Serving Soup & Rolls

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doctors’ day awards

Vincentian Spirit Award

Reina Cruz shows her utmost respect to those she serves in the Central Processing Department. Her main concern is our patients and making sure that the associates in the OR have the instruments needed for their surgeries.

She runs many miles a year between the 1 and 2 floors! nd

Guardian Angel Award

MOST FRIENDLY

Patrick Takahashi, MD

MOST RESPECTFUL

John Chalison, MD

BEST BEDSIDE MANNER

Michael Silao, MD

BEST HANDWRITING MOST RESPONSIVE BEST TEACHER

BEST PATIENT SAFETY ADVOCATE

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Top: From left, Eduardo Lim, MD, Carol Richardson-Te, MD, Ronald Fishbach, MD, and Patrick Takahashi, MD hold their awards. Bottom: From left, President/ CEO Cathy Fickes hands an award to Michael Silao, MD. Bottom right: CNO Kim Deese and the ER Team honor Seung-Ho Choi, MD.

Jan Stein, Executive Director of the St. Vincent Foundation, presents Guardian Angel Awards from grateful patients to House Clinic neurotologist William Slattery, MD, to House Neurosurgical Associates neurosurgeon Marc Schwartz, MD, and to the SVMC ER Team (below). As part of the Guardian Angel program, patients make monetary donations to the St.Vincent Foundation in the names of their Guardian Angels.

PHYSICIAN

MOST COMPASSIONATE

Reina and her co-workers ensure that all instruments are washed, cleaned thoroughly, wrapped and sterilized for when they are needed for the surgical procedures. st

AWARD

Eduardo Lim, MD Carol Richardson-Te, MD Seung-Ho Choi, MD Tariq Shah, MD Ronald Fishbach, MD

BEST NURSE’S ADVOCATE

Randal Arase, MD

BEST MEDICAL RECORD DICTATOR

Wilfredo Hernandez, MD

doctors support signature event Pictured at the March 26 Signature Event, raising support for St. Vincent Medical Center, are Randal Arase, MD and guests; and Ronald Fishbach, MD and guests.

Medical Staff sponsors included: Randal Arase, MD; Ronald Fishbach, MD; Alex Marmureanu, MD; Rafael Mendez, MD; Robert Mendez, MD; Thomas Schmalzried, MD; St. Vincent IPA; St. Vincent Pathology Group; and St. Vincent Radiology Group. More than 45 members of the Medical Staff attended the event held at Dorothy Chandler Pavillion.

Pride of the CCU Award

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Nella Manaytay, RN, Marietta Valledor, RN, Charito Lozado, RN, Pilar Ponce, RN (at back) and CCU Director Sandy Klatt.

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the patient experience: palliative care and pain relief The Survivors

Keeping the Oath to Alleviate Suffering

Recently three longtime cancer survivors returned to the Cancer Treatment Center at St. Vincent Medical Center to thank their physician and the CTC team. They

Linda Lovato, 61, has been coming to the CTC for 10 years

She is always ready to provide emotional support to other patients when they turn to her. “I tell them, ‘It’ll pass and it’ll get a lot better.’ I’ve been a

By Armand Bouzaglou, MD Medical Director, Cancer Treatment Center, SVMC

expressed their gratitude for access to therapies that have extended their lives and controlled their pain.

for treatment of metastatic breast cancer.

She used to work

regular customer here. This is my second home.”

to the World Health Organization, more than seven million deaths worldwide were due to cancer in 2000.

At 82, Cecil Crosby has been living with metastatic prostate cancer for more than 12 years. He Cecil Crosby

has undergone multiple

doses of radiation and takes ongoing chemotherapy three weeks out of every month. He copes with the effects of chemotherapy. If he happens to be in the supermarket when he gets a chemically induced “hot flash,” he spends some time in the freezer aisle. “I just learned to live with it,” he said.

for L.A. County

Linda Lovato

Department of Children’s Services and had to retire. Mrs. Lovato has experienced cancer pain, which disappears after radiation therapy.

“I’ve had radiation to every part of my body. Seems like just after getting

Myung Suk Lee, 59, had to give up

and relieve suffering.

her hairdresser studio after a recurrence of breast cancer

palliative intent to relieve pain and suffering. Palliative care

Cancer Treatment Center – FY 2010

with radiation therapy, while not intended to cure, will provide comfort and relieve pain from bone metastases and improve neurological function from brain or spinal cord lesions. It is also utilized to relieve local symptoms of cough, shortness of breath,

•

12,000 treatment sessions

•

4,000+ of those were to treat cancer with distant metastases

In addition to curing cancer, radiation therapy is used with

in 2004. She

over a treatment, it (cancer) pops up somewhere else.”

underwent Myung Suk Lee radiation treatment for bone metastases and

She has undergone radiation therapy for bone metastases, brain metastases and

remains pain-free, with her cancer under control.

lung metastases over the last eight years.

She remains cancer-free at all of those sites.

Mrs. Lee continues to go to clients’ homes to do their coiffures. She also helps fellow patients to style their hair when she meets them in the CTC. She said through an interpreter: “Dr. (Armand) Bouzaglou is loved by his Korean patients.” SVT

From left, Linda Lovato, Armand Bouzaglou, MD, Myung Suk Lee, and Cecil Crosby gather in front of the linear accelerator to celebrate life and freedom from pain. All three patients were treated by Dr. Bouzaglou in the Cancer Treatment Center.

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The Multi-cultural Health Awareness and Prevention (MHAP) Center staffers distributed daffodils to 80 cancer patients and survivors on March 23. Thanks to Eduardo Lim, MD, Clan Hahn, MD, Armand Bouzaglou, MD and Oncology Nursing Supervisor Jo Aguilar for helping distribute the flowers directly to SVMC cancer patients during Daffodil Days.

For cancer patients, it is important to improve quality of life

Mr. Crosby is glad to offer encouragement to other people undergoing radiation and/or chemotherapy. “To me it’s just like a club. It becomes a family. We’re all going through the same thing.” He remains pain-free and symptomfree 12 years later.

in the news

Much progress has been made in the prevention and treatment of cancer, but deaths from this disease are common. According

bloody sputum or bladder and vaginal bleeding.

Radical new changes in health insurance coverage threaten the delivery of care to cancer patients in physicians’ offices and outpatient clinics.

When coverage for a patient’s palliative therapy is denied on the basis of cost-effectiveness and actuarial life expectancy, the medical community’s imperative to provide palliation from cancer and its complications is being overlooked.

Pain management and optimal care for each patient are integral to the mission of St. Vincent Medical Center (SVMC).

The Cancer Treatment Center team gives patients the fastest possible access to radiotherapy treatments. CTC patients love their doctor, their therapists and the whole team.

I am concerned about the future of palliative care in a costcutting healthcare environment. A concerning trend is emerging

SVMC CANCER TREATMENT CENTER

lately among some HMOs denying coverage for therapies that are palliative and provide comfort to patients experiencing significant pain due to life-threatening tumors.

Fastest Possible Access to Radiotherapy • Consultation to Therapy – 2 to 3 days Free Van Transportation (if needed)

CTC patients achieve quick benefits with appropriate dosing;

Multi-lingual Team of Therapists/Clinician • Korean • Filipino • Spanish • Japanese • Mandarin Chinese • Taiwanese • French

palliative radiation therapy will shrink tumors and control pain and relieve symptoms.

Surprisingly enough, many of our patients treated with palliative intent continue to do much better than anticipated and are alive and cancer-free many years later (see page 4). SVT

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the patient experience: palliative care and pain relief The Survivors

Keeping the Oath to Alleviate Suffering

By Armand Bouzaglou, MD Medical Director, Cancer Treatment Center, SVMC

in the news

Much progress has been made in the prevention and treatment of cancer, but deaths from this disease are common. According to the World Health Organization, more than seven million deaths worldwide were due to cancer in 2000.

The Multi-cultural Health Awareness and Prevention (MHAP) Center staffers distributed daffodils to 80 cancer patients and survivors on March 23. Thanks to Eduardo Lim, MD, Clan Hahn, MD, Armand Bouzaglou, MD and Oncology Nursing Supervisor Jo Aguilar for helping distribute the flowers directly to SVMC cancer patients during Daffodil Days.

For cancer patients, it is important to improve quality of life and relieve suffering.

In addition to curing cancer, radiation therapy is used with palliative intent to relieve pain and suffering. Palliative care with radiation therapy, while not intended to cure, will provide comfort and relieve pain from bone metastases and improve neurological function from brain or spinal cord lesions. It is also utilized to relieve local symptoms of cough, shortness of breath, bloody sputum or bladder and vaginal bleeding.

Cancer Treatment Center – FY 2010 • 12,000 treatment sessions

• 4,000+ of those were to treat cancer with distant metastases

Radical new changes in health insurance coverage threaten the delivery of care to cancer patients in physicians’ offices and outpatient clinics.

When coverage for a patient’s palliative therapy is denied on the basis of cost-effectiveness and actuarial life expectancy, the medical community’s imperative to provide palliation from cancer and its complications is being overlooked.

Pain management and optimal care for each patient are integral to the mission of St. Vincent Medical Center (SVMC).

The Cancer Treatment Center team gives patients the fastest possible access to radiotherapy treatments. CTC patients love their doctor, their therapists and the whole team.

I am concerned about the future of palliative care in a costcutting healthcare environment. A concerning trend is emerging lately among some HMOs denying coverage for therapies that are palliative and provide comfort to patients experiencing significant pain due to life-threatening tumors.

SVMC CANCER TREATMENT CENTER

Fastest Possible Access to Radiotherapy • Consultation to Therapy – 2 to 3 days Free Van Transportation (if needed)

Multi-lingual Team of Therapists/Clinician • Korean • Filipino • Spanish • Japanese • Mandarin Chinese • Taiwanese T • French F

CTC patients achieve quick benefits with appropriate dosing; palliative radiation therapy will shrink tumors and control pain SVT

and relieve symptoms.

Surprisingly enough, many of our patients treated with palliative intent continue to do much better than anticipated and are alive and cancer-free many years later (see page 4). SVT

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awards

Vincentian Spirit Award

Reina Cruz CPD

Vincentian Spirit Award Winner February 2011

Reina Cruz shows her utmost respect to those she serves in the Central Processing Department. Her main concern is our patients and making sure that the associates in the OR have the instruments needed for their surgeries.

Reina and her co-workers ensure that all instruments are washed, cleaned thoroughly, wrapped and sterilized for when they are needed for the surgical procedures.

She runs many miles a year between the 1st and 2nd floors! SVT

Guardian Angel Award

Clockwise: Jan Stein, Executive Director of the St. Vincent Foundation, presents Guardian Angel Awards from grateful patients to House Clinic neurotologist William Slattery, MD, to House Neurosurgical Associates neurosurgeon Marc Schwartz, MD, and to the SVMC ER Team (below). As part of the Guardian Angel program, patients make monetary donations to the St.Vincent Foundation in the names of their Guardian Angels.

Pride of the CCU Award Congratulations to night shift Charge Nurse Marietta Valledor, RN, who received the first “Pride of CCU Spirit Award” for the 4th quarter of 2010.

“We wanted to start recognizing our staff for all their hard work and the individual efforts they give to our patients, families, and other hospital associates,” said Sandy Klatt, Director of the CCU.

From left, Nella Manaytay, RN, Marietta Valledor, RN, Charito Lozado, RN, Pilar Ponce, RN (at back) and CCU Director Sandy Klatt.

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Marietta has worked at SVMC since 1979. She was unanimously voted to receive this award by the staff.

One colleague said it best: “Marietta is exceptionally knowledgeable, accountable, and supportive to her staff. She is an excellent nurse in every respect.” This award will be given to an associate on a quarterly basis. SVT

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patient safety CARE Team CCU

To gain a better understanding of what the CARE anti-sepsis team is accomplishing throughout the house, we’re taking a look at each clinical team, per issue. This month we’ll look at CARE Team CCU.

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A nurse-driven protocol for identifying and treating sepsis will be developed into formal order sets for physician use throughout the hospital.

DOCTORS’ DAY

Each shift, CCU nurses use a sepsis screening tool for all unit patients – except those with DNR orders. They check lactate levels and communicate suspicious levels to physicians.

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NURSES LEAD SEPSIS PREVENTION Clinical Nurse Specialist Dolores Sopuch, RN, provides guidance to the CCU CARE Team members Allan Bayoneta, RN, Chona Pineda, RN, Ellen May Nicolas, RN, and Alicia Rallama, RN.

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The CARE program was initiated throughout the DCHS system as a trend-setting effort to promote National Patient Safety Goals. When St. Vincent Medical Center started its CARE project last August, the hospital already had won CMS rankings for excellent clinical quality.

SharonGreengold@DOCHS.org (213) 484-5593 SusanLauzier@DOCHS.org (213) 484-5525

Sepsis order sets are already in use in the Emergency Department where Medical Director Kevin Chamas, MD also functions as CARE project Physician Champion. Currently, CARE team nurses are leading the effort in the CCU, Med-Surg, and Telemetry to save lives. They are showing fellow nurses how to screen and intervene, identify patients with early manifestations of sepsis, and seek appropriate treatment for them.

Alicia Rallama, RN who has worked at SVMC for 24 years, pointed out that CCU nurses are in a unique position to be able to screen for sepsis because so much clinical patient information is available to them. “We give a very detailed exam to each patient,” she said.

Chona Pineda, RN and Ellen May Nicolas, RN have worked at SVMC for nine years and 30 years, respectively. They have observed that patients now are being transferred from other units earlier than before for treatment of earlyonset symptoms of sepsis.

One severely septic patient, transferred to SVMC from another hospital in February, underwent life-saving treatment and care in the CCU, and then was able to be discharged to home. CCU Team member Allan Bayoneta, RN, who has worked at SVMC for 2 ½ years, said that the CARE program has already proven worthwhile.

“The patients with sepsis are diagnosed sooner.

We don’t get them at their worst. We get them earlier,” he said. SVT

mission integration Serving Soup & Rolls

(213) 207-5783 (800) 371-2176 www.dchsvaluesline.org SVT

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SVMC associates honored the Feast Day of Saint Louise de Marillac (1591-1660) on March 15 by serving free soup and rolls in the Vincentian Café. Along with St. Vincent de Paul, Louise was the co-founder of the Daughters of Charity – the religious congregation of women responsible for so many good works around the world.

Despite her wealth and status, she had always felt God’s invitation to serve the poor with loving compassion. In 1960 Pope John XXIII declared her the “Patron Saint of Social Workers.” SVT

M ardi Gras Is But a Memory!

St. Vincent Medical Center

St. Vincent Medical Center

President/CEO

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Fr. TOM GRIFFIN, S.J.

COVER STORY

CAT H Y F I C K ES

St. Vincent Times

Spiritual Care Director

The time for eating, drinking and being merry is behind us.

We now find ourselves in the season of Lent, an important part of our Christian tradition. It recalls Jesus’ 40-day fast in the wilderness and is an opportunity for our own spiritual renewal. For us, these weeks might include fasting, self-denial – perhaps, no chocolate! penitence – reflecting on, and asking God’s forgiveness for, the ways in which we have failed to love God and others, conversion of our hearts and simplifying our lives.

Lent began with many of us having ashes placed on our foreheads – a good reminder of our frailty and weakness. During this time, we are invited to consider our relationship with God and to free ourselves from those things which prevent us from getting, and staying, closer to God.

Since the purpose of Lent is to transform our lives – body, mind and spirit, we might choose to do some other things as well.

Our life here at St.Vincent offers endless possibilities for positive transformation. In our efforts to be more Christ-like, we could, for example, make a conscious effort to simply smile more often, to escort a lost visitor to an elevator, or to spend an extra compassionate 60 seconds with a patient who is lonely and afraid.

Simple things? Perhaps.

Transformative things? Definitely.

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May your Lent be a time of Spiritual Renewal and your Easter truly Joyful! SVT

St. V incent Times

2131 W. 3rd St. Los Angeles, CA 90057 www.StVincentMedicalCenter.com

ONE DENIAL AT A TIME ENDANGERING PALLIATIVE CARE

doct ors in t he news & lect u re s March 2, 2011 Alexander Marmureanu, MD – Cardiothoracic Surgery Cardiovascular Surgical Symposium – ZÜrs, Austria TOPIC: Minimal invasive approach for treatment of A-fib March 10, 2011 Tae Shin, MD – Orthopaedics/Spine Surgery EveryDayHealth – widely distributed Internet content TOPIC: 10 ways to ease back pain March 13, 2011 Thomas Horowitz, DO – Family Practice KNX newsradio (and other syndicated CBS stations) TOPIC: How the time change (daylight savings) affects the body March 22, 2011 and March 27, 2011 Steven Steinschriber, MD – Ophthalmology KNX newsradio (and other syndicated CBS stations) KTLA - Ch. 5 TOPIC: How 3D video games may affect vision March 31, 2011 Imad El Asmar, MD – Internal Medicine KVEA Ch. 52 TV Spanish-language news TOPIC: P Possible radiation contamination in the commercial milk supply

o ut re a c h & e d uc a t ion Joint Replacement Institute ( JRI) orthopaedist H. Michael Mynatt, MD takes questions from other physicians at a Feb. 24 CME lecture on campus on the topic of blood utilization in orthopaedic surgery.

Out of 138 hospitals, US News and World Report ranked St. Vincent Medical Center among 10 Best Hospitals in Greater Los Angeles!

We l com e Ne w P hy sicians Melvin Jackson, MD

Ashraf Khan, MD George C. Mulopulos, MD

Emergency Medicine Internal Medicine Teleradiology

Jennifer Sohal, MD

Orthopaedic Surgery

Brian Solberg, MD

Orthopaedic Surgery

Alice Song, MD

1st hospital in Los Angeles

Ophthalmology

VINCENTIAN VALUES:

Respect

Compassionate Service

Simplicity

Advocacy for the Poor

Inventiveness to Infinity