St. Vincent Times April 2011

Cancer Treatment Center Takes Aim at Pain Page 4Page 4P

Doctors’ Day Honors and Appreciation Page 3Page 3P

St. V incent T imesONE DENIAL AT A TIME ENDANGERING PALLIATIVE CARE

1st hospital in Los Angeles

APRIL 2011 publication of St. Vincent Medical Center

VINCENTIAN VALUES: Respect Compassionate Service Simplicity Advocacy for the Poor Inventiveness to Infinity

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

APRIL 2011

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

Page 4

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

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St. Vincent Times is a publication for St. Vincent Medical Staff and Associates. Please submit articles as soon as possible prior 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 [email protected] or by calling (213) 484-5593. Medical Staff submissions may also be sent to [email protected]. Or call (213) 484-5525.

Ronald S. Fishbach, MD – chief of medical staff

Cathy Fickes – president/president/president chief executive officer

Sr. Sylvia Parks, DC – chairman of the board

SVT

S t . V i n c e 2

n t T i m e sThank you for making St. Vincent

Medical Center one of the Top 10 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.

This distinction of being ranked 9This distinction of being ranked 9th out of 138 hospitals in out of 138 hospitals in Greater L.A. is based on our care of adults in Ear, Nose & 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.

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.

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.

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

1. Protecting our patients from falls and, 1. Protecting our patients from falls and,

2. Making sure that every person who touches a patient has 2. Making sure that every person who touches a patient has washed his/her hands. The best way that we can protect our 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

c e o n o t e s

President/CEO

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CARE Team CCU

g o t c o n c e r n s ?Physicians may report safety or quality of care concerns:

physician quality hotline: (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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Serving Soup & Rolls

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

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Vincentian Spirit Award

Guardian Angel Award

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.

SVT

Pride of the CCU Award

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

d o c t o r s ’ d a y a w a r d sAWARD PHYSICIAN

MOST FRIENDLY Patrick Takahashi, MD

MOST RESPECTFUL John Chalison, MDMOST RESPECTFUL John Chalison, MD

BEST BEDSIDE MANNER Michael Silao, MDMOST COMPASSIONATE Eduardo Lim, MD

BEST HANDWRITING Carol Richardson-Te, MDMOST RESPONSIVE Seung-Ho Choi, MD

BEST TEACHER Tariq Shah, MDBEST PATIENT SAFETY

ADVOCATE Ronald Fishbach, MD

BEST NURSE’S ADVOCATE Randal Arase, MD

BEST MEDICAL RECORD DICTATOR Wilfredo Hernandez, MD

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.

d o c t o r s s u p p o r t s i g n a t u r e e v e n tPictured 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.

By Armand Bouzaglou, MDMedical Director, Cancer Treatment Center, SVMC

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.

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

and relieve suff ering.

In addition to curing cancer, radiation therapy is used with

palliative intent to relieve pain and suff ering. 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.

Radical new changes in health insurance coverage threaten

the delivery of care to cancer patients in physicians’ offi ces and

outpatient clinics.

When coverage for a patient’s palliative therapy is denied on

the basis of cost-eff ectiveness 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).

I am concerned about the future of palliative care in a cost-

cutting healthcare environment. A concerning trend is emerging

lately among some HMOs denying coverage for therapies that

are palliative and provide comfort to patients experiencing

signifi cant pain due to life-threatening tumors.

CTC patients achieve quick benefi ts with appropriate dosing;

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

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. Th ey

expressed their gratitude for access to

therapies that have extended their lives

and controlled their pain.

At 82, Cecil

Crosby has

been living

with metastatic

prostate cancer

for more than

12 years. He

has undergone

multiple

doses of radiation and takes ongoing

chemotherapy three weeks out of every

month. He copes with the eff ects of

chemotherapy. If he happens to be

in the supermarket when he gets a

chemically induced “hot fl ash,” he

spends some time in

the freezer aisle. “I just

learned to live with it,”

he said.

Mr. Crosby is glad to

off er 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 symptom-

free 12 years later.

Linda Lovato,

61, has been

coming to the

CTC for 10 years

for treatment

of metastatic

breast cancer.

She used to work

for L.A. County

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

over a treatment, it (cancer) pops up

somewhere else.”

She has undergone radiation therapy for

bone metastases, brain metastases and

lung metastases over the last eight years.

She remains cancer-free at all of those

sites.

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

regular customer here. Th is is my second

home.”

Myung Suk Lee,

59, had to give up

her hairdresser

studio after a

recurrence of

breast cancer

in 2004. She

underwent

radiation

treatment for bone metastases and

remains pain-free, with her cancer

under control.

Mrs. Lee continues to go to clients’

homes to do their coiff ures. 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

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S t . V i n c e n t T i m e sThe Survivors

t h e p a t i e n t e x p e r i e n c e : p a l l i a t i v e c a r e a n d p a i n r e l i e f

Cancer Treatment Center – FY 2010

12,000 treatment sessions•

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

SVMC CANCER TREATMENT CENTER

Fastest Possible Access to RadiotherapyConsultation to Th erapy – 2 to 3 days•

Free Van Transportation (if needed)

Multi-lingual Team of Th erapists/ClinicianKorean• Filipino • Spanish• Japanese• Mandarin Chinese• Taiwanese• French•

Linda Lovato

Cecil Crosby Myung Suk Lee

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.

Th e 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 n t h e n e w sTh e Multi-cultural Health Awareness and Prevention (MHAP) Center staff ers distributed daff odils to 80 cancer patients and survivors on March 23. Th anks to Eduardo Lim, MD, Clan Hahn, MD, Armand Bouzaglou, MD and Oncology Nursing Supervisor Jo Aguilar for helping distribute the fl owers directly to SVMC cancer patients during Daff odil Days.

By Armand Bouzaglou, MDMedical Director, Cancer Treatment Center, SVMC

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.

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.

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).

I am concerned about the future of palliative care in a cost-cutting 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.

CTC patients achieve quick benefits with appropriate dosing; 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

Keeping the Oath to Alleviate Suffering

SVT

5

S t . V i n c e n t T i m e sThe Survivors

t h e p a t i e n t e x p e r i e n c e : p a l l i a t i v e c a r e a n d p a i n r e l i e f

Cancer Treatment Center – FY 2010• 12,000 treatment sessions• 4,000+ of those were to treat cancer

with distant metastases

SVMC CANCER TREATMENT CENTERFastest Possible Access to Radiotherapy• Consultation to Therapy – 2 to 3 daysFree Van Transportation (if needed)Multi-lingual Team of Therapists/Clinician• Korean• Filipino • Spanish• Japanese• Mandarin Chinese• TaiwaneseTaiwaneseT• FrenchFrenchF

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 n t h e n e w sThe 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.

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

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Reina CruzCPD

Vincentian Spirit Award Winner

February 2011

Vincentian Spirit Award

Guardian Angel Award

a w a r d sa w a r d s

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.

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.

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

Pride of the CCU Award

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

COVER STORY

Page 4

DOCTORS’ DAY

Page 3

NURSES LEAD SEPSIS PREVENTION

Page 7

[email protected] (213) [email protected] (213) 484-5525

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.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.

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

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President/CEO

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St. V

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p a t i e n t s a f e t yCARE Team CCU

(213) 207-5783

(800) 371-2176www.dchsvaluesline.org

ardi Gras Is But a Memory!

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. May your Lent be a time of Spiritual Renewal and your Easter truly Joyful! 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 i s s i o n i n t e g r a t i o n

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.

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.

Serving Soup & Rolls

outreach & educat ion

St. V incent T imes2131 W. 3rd St.Los Angeles, CA 90057www.StVincentMedicalCenter.com

ONE DENIAL AT A TIME ENDANGERING PALLIATIVE CARE

1st hospital in Los Angeles

doctors in the news & lectures

March 2, 2011Alexander Marmureanu, MD – Cardiothoracic SurgeryCardiovascular Surgical Symposium – ZÜrs, AustriaTOPIC: Minimal invasive approach for treatment of A-fib

March 10, 2011Tae Shin, MD – Orthopaedics/Spine SurgeryEveryDayHealth – widely distributed Internet contentTOPIC: 10 ways to ease back pain

March 13, 2011Thomas Horowitz, DO – Family PracticeKNX newsradio (and other syndicated CBS stations)TOPIC: How the time change (daylight savings) affects the body

March 22, 2011 and March 27, 2011Steven Steinschriber, MD – OphthalmologyKNX newsradio (and other syndicated CBS stations)KTLA - Ch. 5TOPIC: How 3D video games may affect vision

March 31, 2011Imad El Asmar, MD – Internal MedicineKVEA Ch. 52 TV Spanish-language news TOPIC: Possible radiation contamination in the commercial Possible radiation contamination in the commercial P

milk supply VINCENTIAN VALUES: Respect Compassionate Service Simplicity Advocacy for the Poor Inventiveness to Infinity

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!

Emergency Medicine

Internal Medicine

Teleradiology

Orthopaedic Surgery

Orthopaedic Surgery

Ophthalmology

Welcome New Physic iansWelcome New Physic iansWelcome New Physic iansMelvin Jackson, MD

Ashraf Khan, MD

George C. Mulopulos, MD

Jennifer Sohal, MD

Brian Solberg, MD

Alice Song, MD