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Common Ground: Magnet® message and August Breakfast with CEO recap
Oct. 5, 2014


In the news:  

Coming events:  

FluGet your flu shot by Nov. 14
The No Flu Here League has begun and there are more than a dozen opportunities on campus to get your flu shots between now and Nov. 14. If you choose exemption, please complete the  exemption request form and email to Kelli Fussell in the Medical Staff office along with documentation of medical contraindications by Nov. 1. Exemption requests will be taken to the Medical Executive Committee (MEC) for consideration. If you have received your vaccination elsewhere, please turn in or email your documentation to the medical staff office or employee health by Nov. 14.

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MagnetMagnet® message:  Patients help develop Exemplary Professional Practice
The Salem Spine Center is working to develop exemplary professional practice by tapping patients, patient families, physicians and community partners for new knowledge that will help improve patient care every day. Read the full story.


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BfstwCEOBreakfast with CEO recap
At the August Breakfast with CEO, physicians asked questions regarding ED wait times, the Salem Hospital hospitalist program, the recruitment of a new Chief Medical Officer and the affiliation with OHSU. 

Read those questions and Norm Gruber's responses.
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ClinicalDocClinical Documentation Improvement tips
Some clarity around documenting is given in a recent Clinical Documentation Improvement update as well as kudos to Dr. Rafiq for assisting in the verbal query process. Read the full update here

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IanLoewenThomasWe want to hear from you:  Complete our readership survey
We have been using Common Ground as our main means of communication for the past six months and would like to take this opportunity to evaluate how we're doing. Please take a minute to complete a short 5-question survey and let us know your input. We appreciate your feedback as we strive to make Common Ground an effective communications tool for the Salem Health Medical Staff. Take the survey here. 

Ian Loewen-Thomas, M.D.
Chair, Compact Implementation Committee

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ChadwickPreston W. Chadwick, MD - Dermatology  
Dermatology Clinic, PC
Medical Education:
Drexel University College of Medicine - Philadelphia, Pa.
Aug. 2006 to May 2010
The Lankenau Medical Center
 Wynnewood, Pa. 
June 2010 to June 2011
Cooper Medical School of Rowan University
Camden,  N.J.    
July 2011 to June 2014


DaGracaDaniel I. Da Graca, MD - Hematology Oncology
Central Interstate Medical Office


University of Miami Miller School of Medicine
Miami, Fla.
June 2004 to May 2008
Internal Medicine
Baylor College of Medicine
Houston, Texas
June 2008 to June 2009
Internal Medicine
Baylor College of Medicine  Houston, Texas     
July 2009  to June 2011
Hematology Oncology
Baylor College of Medicine  Houston, Texas
July 2011 to June 2014
Board Certification:
American Board of Internal Medicine


HumphreysJames C. Humphreys, CCP - Perfusionist

Northwest Surgical Associates, Inc.


Medical Education: Duquesne University -
Pittsburgh, Pa.
May 1993
Board Certification: American Board of Cardiovascular Perfusion






RodriguezCristino Rodriguez, NP - Family Nurse Practitioner

Willamette Health Partners  



Nurse Practitioner Education:
Eastern Kentucky University
Richmond, Ky.
Jan. 1978 to Aug. 1978
Board Certification: American Nurses Credentialing Center/Nurse Practitioners


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HospitalistsHospitalists receive Healthgrades awards 
Michael Hanslits, MD, presented the following Healthgrades awards to the hospitalists on Monday, Sept. 15, at their section meeting:
  • Five-Star Recipient for Treatment of Sepsis for 5 Years in a Row
  • Five-Star Recipient for Treatment of Respiratory Failure in 2014
  • Five-Star Recipient for Treatment of Pulmonary Embolism in 2014
  • Five-Star Recipient for Treatment of Pneumonia for 2 Years in a Row
Back row, l to r:  Raymond E. Westermeyer, MD; Bob Brannigan; Michael Hanslits, MD; Syed Zaidi, MD; Abdul Mohsin, MD; Gloria C. Alexander, MD; David Tate, MD.  Front row, l to r: Christopher G. Mapa, MD; Anda Yangson, MD; Marc J. Sunday, DO; Natalie A. Melrose, MD; Richard Hunt, MD; Preethi Prakash, MD; Lisa R. Matlock, FNP
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SpokaneToSandpointSalem Health team takes first in Spokane to Sandpoint Relay
A team of Salem Health physicians and staff competed in the 200-mile Spokane to Sandpoint Relay this past August and finished first in the Corporate Division. Congrats team!
Back to front, l to r:  Mike Bee; Jay Bonzani; Henry Troung, MD, ED physician; Lazeni Koulibali, DO, ED physician; Samuel Pino, Interpretive Services Supervisor; Brandon Schmidgall, RN, CV Services Director; Karissa Hudspeth, RN, ED; Steve Hudspethl; Erik Schmidgall; Nancy Bee, ANM, ED; Kelsey McCann, RN, ED; Rachel Koulibali, RN, Adult Health
SCINewly updated Salem Cancer Institute hosts open house
With beautiful new facility upgrades to showcase, as well as expanded programs and offerings, the Salem Cancer Institute hosted an open house for the community on Thursday, Sept. 25. The $4 million project creates a healing and comforting place for cancer patients to receive quality treatment and expertise from health care professionals.  Read the full Statesman Journal story.

Salem Health CEO Norm Gruber quoted in Hospital & Health Networks article on hospital partnershipsGruber
In a recent Hospitals & Health Networks (H&HN) Daily article on new emerging models for health care delivery systems, Salem Health CEO Norm Gruber states the importance of gaining broader perspectives on industry dynamics driving change and getting full buy-in from the board.  Read the full Hospitals & Health Networks story.

CHECFor your patients, from the CHEC
Exercise Ball
Participants will improve posture and back health, promote muscular balance and enhance mobility.
  • Mondays, Wednesdays and Fridays, Oct. 13 through Nov. 7
  • 11:30 a.m. to 12:15 p.m.
  • $40
Read the flier
Walk with Ease
A nine-week program designed by the Arthritis Foundation for those who experience arthritis, but anyone who wishes to increase their walking endurance is welcome to join.
  • Tuesdays and Thursdays, Oct. 14 through Dec. 11
  • 9 to 10 a.m.
  • $10
Walk with Ease Advanced
For the more advanced walker who is currently able to walk at least a mile and would like to work on improving their pace.
  • Tuesdays and Thursdays, Oct. 14 through Dec. 11
  • 8 to 9 a.m.
  • $10
Read the flier
Healthy Back Class
Participants learn how to keep their back strong and decrease their risk of injury.
  • Thursday, Oct. 23, at West Valley Hospital
  • 3 to 4 p.m.
  • $5
Sleep Apnea Support Group
Led by Salem Hospital's Sleep Center for sleep apnea patients and family members.
  • Thursday, Oct. 9
  • 6:30 to 8 p.m.
PPDPositive patient identification system to go live in ED
Effective October 14, the laboratory positive patient identification (PPID) system will go live in the ED with the phlebotomy, RN and respiratory therapy teams.

Salem Hospital is implementing a PPID System for blood draws and eventually all specimen collection. This change brings our hospital practices in line with nationally recognized best practices that ensure patient safety. Salem Hospital's laboratory processes approximately 135,000 specimens annually and our hospital averages 350 Patient Safety Alerts for mislabels annually.

The PPID system uses handheld scanning technology to confirm patient identity and print labels at the bedside.
PPID eliminates rework and improves patient safety. Because the patient's identification bracelet will be scanned when samples are collected, the technology will raise patient satisfaction by reducing patient "sticks" through re-collections.  

The hospital's goal is to eliminate labeling errors, which can result in misdiagnosis and inappropriate treatment. The new technology is consistent with the hospital's system for dispensing medication.

The rollout of PPID is occurring in phases with ED and respiratory therapy IP as Phase II. The final rollout will be for all inpatient nursing staff in November. The hospital will train 36 super users for support during this workflow change.
For more information, contact Gordon Johnson, manager, laboratory support services, 503-562-1110.   

Please be aware of lab system downtime on Oct. 7, from 9 to 10 a.m., to upgrade interfaces for Meaningful Use. During this time, inpatient lab results will move to paper. Orders will continue to flow as usual. Please keep the following information in mind and see MyEpic/Radar for a tip sheet with more information.
  • Inpatient results will be faxed to the floors.
  • All critical values will continue to be telephoned to the floors.
  • All results will be stored in instruments and printed at the completion of the downtime.
  • Test results for specimens received in the lab and resulted during the downtime will not be viewable in Epic until the lab system is back online.
  • Inpatient results will be printed inside the lab and cross-checked to ensure all results cross over electronically.
  • Outpatient results will not be faxed to the ordering provider.
  • Outpatient critical values will continue to be called to the ordering provider.
  • Test results for outpatient specimens received in the lab and resulted during downtime will not be viewable in Epic until the lab system is back online.
  • Outpatient results will be printed and cross-checked to ensure all results cross over electronically.
There will be a command center in place to support this go-live. Please call 503-561-4357 and select 1 for command center.

The Physician Leadership Committee met on Sept. 18. Following is a summary of action items that resulted: 
  • Further investigation on delinquent medical record process and proposed revisions to rules and regulations will take place and be revisited at a future meeting.
  • Proposed revision to the Credentials Procedure Manual is being withdrawn.
  • A group of appointed physicians will gather to discuss and problem solve patient care hand-off workflow and bring resolution back to the PLC.

Read the  complete minutes from the meeting.


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MPRCMultidisciplinary Peer Review Committee endorses General Surgery Section recommendation for removal of post-operative drain
The Multidisciplinary Peer Review Committee (MPRC) endorses the following recommendations developed by the General Surgery Section in an effort to ensure removal of the correct post-operative drain when multiple drains are present.

1)    Patients with more than one drain should have their drains clearly labeled, preferably by the surgeon.
2)    If a surgeon asks a nurse to remove a drain in a patient with more than one drain, the surgeon must clearly state and identify in the EPIC order which drain is to be discontinued.

The MPRC and General Surgery Section encourage all services, where relevant, to adopt these recommendations.

HeatHeat shutdown in Building B on Oct. 8
Heat will be shut down in the North Tower of Building B between the hours of 6 a.m. and
3 p.m. on  Wednesday, Oct. 8. Work will be performed during this time on the heating water lines as part of the 5/6 NW Nursing Unit Renovation. This shutdown does not impact domestic water so there will be no impact to hot water at sinks and for bathing.

SBARSBAR for hospitalists:  Nuclear medicine gastric emptying days changed

Situation: Nuclear Medicine gastric emptying days have changed from Tuesday to Wednesday as of July 1, 2014. All (inpatient and outpatient) gastric emptying exams will now be completed on Wednesdays.

Background: Gastric emptying studies were performed on Tuesdays prior to July 2014. Timeliness for patient care was compromised on this day due to other scheduled exams which had a negative impact on patient satisfaction. Due to this issue gastric emptying day was moved to Wednesdays for all patients.

The exam takes about 4.5 hours to complete with multiple scan times throughout that time period, so doing all gastric emptying exams on one day has allowed for the most efficient use of room time for this study while minimizing the impact to other patients. Inpatient studies will be scheduled and completed with the outpatient studies on Wednesdays. If time allows for an inpatient gastric emptying study on other days, the patient will be completed as soon as possible after the order is placed. Each time an inpatient gastric emptying order is placed, the Nuclear Medicine Department will contact the patient's RN to inform them when the exam will be able to be completed.

Recommendation: Order nuclear medicine gastric emptying studies to be done as an outpatient whenever possible. If it is not possible, understand that the Nuclear Medicine Department will do all they can to get the inpatient gastric emptying study completed ASAP, but the study may have to wait until the Wednesday following the order date.

Contact Imaging Services Manager, Justin Millar, at 503-814-1227 or Nuclear Medicine Lead Technologist, Rachel Lacy, at 503-814-9728, if you have any questions.

EXPARELLiposomal bupivacaine (EXPAREL) approved for hip or knee replacements

Liposomal bupivacaine (EXPAREL) was provisionally approved by the Pharmacy and Therapeutics (P & T) Committee for hip or knee replacement in late 2013 on the condition that surgeons would study outcomes associated with the use of the medication to determine if the cost was justified by clinical outcomes. In August, Dr. Dolan returned to P&T with data showing reduced pain scores, reduced use of the femoral nerve block and plans to expedite
discharge of patients who did not receive a femoral nerve block. Based on this information,
P&T gave full approval for orthopedics to continue use of EXPAREL.

Currently, EXPAREL is P&T approved ONLY for use in patients who are undergoing knee or
hip replacement. Providers who wish to use this medication for any other indication are
invited to submit a formulary request and outline a plan that demonstrates use for other
procedures is a cost-effective use of hospital resources.
Common Ground Newsletter Editorial Board 
For past issues of this newsletter, visit
Email us anytime with feedback, suggestions, or something for the next issue!  Dr. Ian Loewen-Thomas, Chair, Compact Implementation Committee

Salem Health