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Common Ground at Salem Health, April 20, 2014
April 20, 2014
Hanslits Understanding our Compact
  • The way we work together
  • Our obligation to seek to understand each other
  • Business decisions 

By Ian Loewen-Thomas, MD  

on behalf of the CIC


Salem Hospital has something special: a Compact between our medical staff, our administration and our board that governs how we work together. The Compact supports our shared vision to provide an exceptional experience every time-- for our patients and the people who work here.


Through implementation of the Compact, we seek to create an environment of trust and respect through the following behaviors:

  • Assuming good intentions
  • Asking questions to understand others' decisions and interests
  • Collaborating
  • Taking responsibility for being informed

The Compact also reflects the reality of operating a large organization. Medical staff leadership works directly with hospital administration and the board.     


The 600 members of the hospital medical staff have many opportunities to participate in decision-making or provide feedback. We encourage you to participate in committees and other processes to share your perspective.  


One of the most important decisions you will make is your choice of leadership. Your leaders are your representatives to the administration and the board.  


The Board's role under the Compact? "Prior to making significant decisions, provide opportunities for Medical Staff physician leaders and Administration to be engaged and have perspective understood and considered."


As a valued member of our medical staff, we encourage you to read the Compact and play an active role in ensuring its success.


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UpdateCompact Implementation Committee update
On April 2, the CIC addressed several topics including new physician orientation, recruitment and the role of CIC. Read the update.

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hearWe want to hear from you!
You might be familiar with Rumor Has It, our regular postings on the Salem Health intranet of questions submitted by staff and answered by the appropriate member of leadership.

We'd love to hear your questions and provide answers in this regular column. 
Feedback on this newsletter is also welcome! Help us improve this communication model to be effective and efficient.

Email us at

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communicationboardCommunication Board premiers in Building A
  • New tool improves communication
  • Opportunity for service lines to share information
  • Visit often to learn more

The Common Ground Compact, a partnership among physicians, board members and hospital administration, clarifies and strengthens the relationship of the board, hospital administration and medical staff. The Compact Implementation Committee (CIC) works to assure that efforts at Salem Health to improve quality, safety, efficiency, value and access align with the principles established in the compact.   


Communication is a primary focus of the CIC. In addition to this e-newsletter,  a "communication board" now provides medical staff with another highly visible source of information. Find it in the main hallway of Building A (near surgery and the adjacent sky bridge).  


Mary Maberry, Physician Office Liaison, can answer any questions about the board. She and members of the medical staff will update the information monthly. The board will feature service lines on a rotating basis, with two postings each month.   


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Here's where you will find changes to Epic order sets, best practice advisories and reports from the Physician Leadership Council.
virusAdenovirus causing severe respiratory illnesses in Oregon
  • Several cases at Salem Hospital identified through routine testing
  • Preventive measures, include hand hygiene, droplet and contact precautions
  • Contact Nancy O'Connor, Infection Prevention and Employee Health Manager, with concerns and new cases

On Friday, April 18, the Oregon Health Alert Network issued an advisory about an increased incidence of severe respiratory illnesses caused by adenovirus. The Oregon Public Health Division, local public health departments and the Centers for Disease Control and Prevention are working to characterize these illnesses.


At the same time, Salem Hospital has identified three cases of adenovirus in critical care. We have notified the county health department and have implemented measures to prevent the spread of disease:

  • Using droplet and contact isolation for the duration of illness for patients diagnosed or suspected of having adenovirus pneumonia and other respiratory infections of unknown etiology.
  • Wearing gowns, gloves and masks when with patients who have adenovirus pneumonia.
  • Practicing proper and frequent hand hygiene to decrease the risk of transmission.
  • Following proper respiratory hygiene and cough etiquette.

Contact Nancy O'Connor, Infection Prevention and Employee Health Manager, with concerns and new cases, (503) 561-2606.


Read more: 

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ErxEPrescribe comes to Salem Hospital
  • EPrescribe starts May 6  
  • Most pharmacies accept ePrescribe
  • Superusers on your floor to help

EPrescribe reduces the time patients must wait at a pharmacy for needed medications after discharge.  


Informatics Coordinators will train the superuser in each unit. All clinical staff will complete an eLearning via HealthStream on workflow changes.  


An FAQ is available now on the Medical Staff Website and will be provided via the red Epic message box when you log in, beginning in May.


Controlled medications (schedule II, III, IV and V drugs) are not eligible (yet). 


Contact Lisa Wood for more information.   


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rxtrainProvider training: EPrescribe and BPAs
  • Provider training for ePrescribe and Epic Best Practice Advisories (BPAs)
  • Building B Basement Computer Lab 3, near old cafeteria
  • April 28, 29, 30 and May 1.

Are you noticing more yellow BPAs in Epic? Ever wonder why they exist and what you should  do with them?  


Come to one of these playground/demo sessions:


April 28
10 a.m. to Noon
April 29
12:30  to 2:30 p.m.
April 30
2 to 4 p.m.
May 1
6 to 8 a.m.

We'll also cover the basics of ePrescribe, the new prescription printing feature going live May 6. Contact Lisa Wood for more information.

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delayICD-10 training delayed

  • Training delayed for one year
  • Epic transition to begin early
  • Dual coding continues

On March 27 and March 31 respectively, the US House of Representatives and the US Senate voted to postpone ICD-10 implementation until October 1, 2015.


The delay did not diminish the need for coders, care managers, access services and billing staff to learn ICD-10 code sets, so Salem Hospital began ICD-9 and ICD-10 dual coding on April 1.


Salem Hospital's Medical Executive Committee decided they would not proceed with requiring ICD-10 education and competency of all credentialed providers for at least one year.


The delay allows Salem Health to begin the Epic upgrade earlier. Read Common Ground for more information about the Epic project as it becomes available.  


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clinicalClinical Technology Assessment Committee chartered
  • New committee brings consistency to decision-making
  • Provide a clear process for physicians to bring new technology to Salem Health
  • Use evidence to support decisions
The Physician Leadership Council reviewed a proposed charter for a new Clinical Technology Assessment Committee at its April 17 meeting. Committee will have five physician members appointed by the Medical Engagement Committee and five appointed by the Executive Leadership Council. It will review new technology with an impact of $250,000 or more in operating or capital funds.

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PAPhysician Assistant (PA) Peer Review

  • All clinical peer review determinations apply to PA and attending physician
  • There are no "adverse determinations"
  • Transparency is our goal

The following from Dr. Jennifer Williams, MD, Multidisciplinary Peer Review Committee Chair, provides more clarification on the peer review process for physician assistants:

  • If a physician assistant is involved with a case referred to Peer Review, the attending physician for the patient in the case, is directly responsible for all clinical care provided by the PA, will also be similarly subject to peer review.
  • The attending physician along with the PA shall be notified of the case as soon as it is referred for peer review and be given the opportunity to respond to concerns about the case.
  • Clinical peer review determinations assigned to physician assistants will also be assigned to the attending physician for the patient involved in the peer review case.
  • A copy of the outcome letter to the PA and the attending physician will also be sent to the PA's supervising physician of record, along with a copy of the Oregon Medical Board regulations and Medical Staff Bylaws defining the role of the supervising physician in the oversight of PA patient care.

Clarification: The reference to "attending" refers to the responsible attending physician for the patient at the time the incident occurred.  


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skinSkin Care Policy updated

  • Redrafted to address need of clinical staff
  • Clarifies how to initiate protocol
  • Explains documentation and treatment guidelines

A draft Skin/Wound Care protocol update provides prevention strategies and nursing care guidelines for skin/wound assessment and preventive treatment. It clarifies that a provider must order the protocol. Read the draft.


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restraintRestraint policy updated
Salem Health has revised its policy for Use of Restraint and/or Seclusion. The revisions reflect Centers for Medicare and Medicaid Services requirements. Any physicians who order restraints or seclusion must demonstrate a working knowledge of this policy through ongoing compliance.

The revisions cover:
  • Immediate physician notification and order receipt upon emergent restraint application for both behavioral or patient safety/protection reasons.
  • New death reporting requirements.

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spinalEpic Priority Consult interface for spinal triage documentation


Beginning April 23, 2014, physicians at Salem Health will have access to an interface between the Priority Consult Software System and Epic. The interface will make Salem Spine Center triage documentation viewable in Epic under the Notes/Trans tab in Epic Chart Review.


Find spinal consults under the category of Spine Center Phone Triage. Find a tip sheet with more information on the Physician MyEpic/Radar bulletin page.


For more information, contact Jane Ray at 503-561-2235.   


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shigaRoutine testing for Shiga toxin-producing Escherichia coli  
  • Client update provides standards for specimens
  • Samples positive for shiga toxin 1 or 2 will be reported to public health
  • Daily testing
In response to Centers for Disease Control and Prevention recommendations, Salem Health will now test all stool samples for STEC. No additional orders required. Read more.

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HealthgradesSalem Hospital receives Healthgrades 2014 Outstanding Patient Experience Award

Thank you to our medical staff for helping us achieve the  Healthgrades Outstanding Patient Experience Award for the second consecutive year.  


This distinction places Salem Hospital among the top 10 percent of hospitals in the nation for patient experience. Salem Hospital was honored for providing  positive experiences for patients during their hospital stays. Salem Hospital is the only large hospital in Oregon to be honored. Read more


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MedAssist10th annual Med Assist Benefit event

Friday, April 25, 6:30 p.m. 

Historic Elsinore Theatre

Sponsored by the Medical Foundation of Marion and Polk Counties.

Tickets available at the Elsinore Theatre box office (503) 375-3574 or online.   


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forumsApril 23 affiliation forums canceled

  • New May dates to be announced 

Due to scheduling conflicts, we have to cancel the affiliation forums scheduled for April 23. We look forward to talking with physicians when we reschedule the forums for May.  


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familyFamily Medicine Day set May 9
  • Lance Loberg, M.D., plans a full day of presentations.

Friday, May 9, 2014

7 a.m. to 5 p.m.

Salem Conference Center

200 Commercial St SE

Salem, Oregon 97301


See the full agenda and registration guidelines    


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CHECFor your patients
  • Community Health Education Center offers a variety of classes

Please consider referring your patients to any of these Community Health Education Center offerings. They provide local, low-cost ways to improve health and get support.  


Some upcoming opportunities:

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PLCGet your issue, concern or problem addressed


To use the Physician Leadership Council (PLC) Problem List, just submit your issue, concern or problem.

  • Each problem is assigned a leader
  • Action towards resolution is tracked by your Officers and Section Chiefs
  • Produces increased transparency and accountability

Submit issues, concerns, and questions to Kelli Fussell or contact one of your Medical Staff leaders with any items you would like to discuss.


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Governance Institute features Salem Hospital's PLC
A special study of hospital boards' role in developing physician leaders led the reporter straight to Salem Health's Dr. David Holloway and our Physician Leadership Council.

Elaine Zablocki, who wrote the piece, found the PLI impressive on several fronts, particularly calling out its "homegrown flavor" and  "the level of engagement throughout the hospital."
Read the full article.

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Business Journal covers impact of ICD-10 delay
Salem Health Chief Information Officer Cort Garrison responded to questions about the impact on operations and the costs of delay. Read more.

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Willamette Health Partners Names Executive Medical Director

Ralph Yates, DO, will join Willamette Health Partners on May 12.   He is a graduate of Kirksville College of Osteopathic Medicine and serves on the Oregon Medical Board.  


Dr. Yates comes to WHP from Portland Clinic, where he serves as Branch Medical Director. He is also Medical Director and President of the Board of Portland Coordinated Care Association and Chair of the ADA Research Foundation. 


His new duties include serving as Chair for the WHP Medical Leadership Council, participating on our Network Operating Council, developing clinical protocols and systems, providing leadership and mentoring to our Medical Directors, providers. Dr. Yates will continue his clinical work in family medicine two days per week.

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Renee Rash named cardiovascular ops manager  

Salem Health welcomes the return of Renee Rash. Rash started in 1996 as an Exercise Specialist intern at Salem Hospital in Cardiac Rehabilitation.  After she graduated from Western Oregon with a Bachelor's of Science in physical education, Salem Health brought her onto the staff.

Rash graduated from nursing school in 2004, after which she worked at both Santiam and Silverton hospitals in emergency, surgery and mother/baby. She served as a Resource RN, house supervisor and assistant nurse manager at Silverton Hospital.
whpWillamette Health Partners campaign to begin April 30
  Willamette Health Partners begins a marketing campaign soon in three phases:
  1. Need a doctor? Newly insured? (Direct mail, Statesman Journal website, Facebook)
  2. Welcome Dr. Keita Sakon (This is direct mail only to the Dallas market. He will be seeing patients there one day per week.)
  3. WHP clinic locations (Direct mail, print advertising in Salem, Polk County)
Read more. If you have questions, please contact Jan Miller, System Director of Marketing.
Common Ground Newsletter Editorial Board 
Email us anytime with feedback, suggestions, or something for the next issue!
Dr. David Holloway, CMO, Dr. Michael Hanslits, Medical Staff President
 Dr. Ian Loewen-Thomas, Chair, Compact Implementation Committee

Salem Health