In This Issue DEA Rescheduling of Hydrocodone Combination Products.……………..P 1 Influenza Vaccination……………....P 1 Shortage of Normal Saline IV and Irrigation Solutions.…….…...…P 2 HIPAA Tip……………………………P 3 Medical Executive Committee Approvals…..………………………..P 4 Medical Staff Calendar....….……....P 5 Physician Roster Updates……....…P 6

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MONTHLY

MEDICAL

STAFF

NEWSLETTER ProgressNotesVOLUME 6

O c t o b e r

DEA Rescheduling of Hydrocodone Combination Products

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Effective October 6, 2014 the Drug Enforcement Administration (DEA) will reschedule Hydrocodone Combination Products from Schedule III to Schedule II. You will need to follow all of the Schedule II regulations when prescribing these drugs.

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All Medical Staff members (physicians and non-physicians) shall either receive the influenza vaccine this year or complete the declination form and wear a mask. Vaccinations are being offered at various Medical Staff meetings, the General Staff Meeting on November 5th, or in the Employee Health Services Department starting October 2nd from 6:00 a.m. - 12:00 p.m. and 1:00 p.m. - 4:00 p.m. (please bring your ID badge to receive the vaccine). Vaccinated physicians will receive stickers that are to be displayed on their ID badges. Please forward confirmation of vaccination to the Medical Staff Services Department either by fax to (310) 784-8762 or by email to medicalstaff@tmmc.com. If you do not wish to be vaccinated, please advise the Medical Staff Services Department by email and request a declination form. Medical staff members who do not have a proof of vaccination by November 1, 2014 will be required to wear a mask from November 1, 2014 through March 31, 2015. If you have questions please contact the Medical Staff Services Department at (310) 517-4616

Influenza Vaccination

To: TMMC Medial Staff and Employees From: TMMC Pharmacy Department Re: Shortage of Normal Saline IV and Irrigation Solutions Date: September 4, 2014

Torrance Memorial Medical Center is experiencing shortages of IV NS and NS for irrigation due to a nationwide shortage. This shortage is expected to continue through the remainder of 2014. Conservation is key!

Summary: There is a National shortage of both Intravenous and Irrigation fluids. The reason for this shortage is related to increase market demand as well as challenges in manufacturing. All formulations of intravenous and irrigation solutions are included in this shortage; however Torrance Memorial is being severely impacted by the shortages of NS IV 1000ml and NS 3000ml Irrigation Solution. All procedural and patient care areas are expected to assist with conservation strategies.

All Medical Staff and Patient Care Area Physicians and staff should do everything possible to conserve IV and irrigation fluids, especially NS and LR. Recommended strategies:

· Utilize oral hydration whenever feasible · Stop IV hydration as early as possible · Only use TKO fluids when required to facilitate low rate mediation infusions · Whenever possible utilize solutions that are less impacted (0.45% NS, D5/0.45%NS, D5LR) · Utilize bladder irrigation only when necessary and at the lowest rate possible · Nursing staff: hang appropriate bag size based on the order (i.e. utilize 500ml bags for 500ml bolus)

Surgical and Procedural areas · The pharmacy will continue to prepare bacitracin + polymixin in NS 3000ml irrigation bags as long as supply is availa-

ble. When NS 3000ml Irrigation bags are not available, the pharmacy may mix bacitracin + polymixin solutions in NS 1000 ml or 2000ml based on solution availability.

· Utilize bacitracin + polymixin irrigation in 1000ml pour bottles whenever possible. · Evaluate total fluid requirements. The American College of Surgeons: Principles and Practice 2014 noted that total

volume needs for elective surgeries are much less (500 to 3000ml) than previously thought (4500�6000ml). · The OR staff is aware of the shortage and will assist the surgeons with conservation and obtaining necessary avail-

able solutions.

Thank you for assisting TMMC with these conservation methods.

Steven Thompson, Pharm.D. Director of Pharmacy Services

Shortage of Normal Saline IV and Irrigation Solutions

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QUESTION: CAN I SEND OUT AN E-MAIL CONTAINING PROTECTED HEALTH INFORMATION (PHI) ABOUT A PATIENT?

ANSWER: The Privacy regulations permit the use of e-mail as long as the content is secure and the following guidelines are met:

Internal and External E-mails; May contain a patients’ name and minimal PHI, PROVIDED the following guidelines are met:

1. Clinical messages with patient PHI (minimum necessary) must be transmitted from one clinician to another for purposes related to the patients’ care and NOT broadcast to a distribution list;

2. E-mail should not contain the patients’ name or medical record number in the subject field;

3. Clinical e-mail must be promptly deleted after being read. Clinical e-mail messages must not be saved or archived on a PC;

4. Patient specific e-mail communications between clinicians should be documented in the patients’ paper medical record; and

5. Patient specific messages which reference highly sensitive information, e.g. relating to mental health or HIV, MUST NOT contain the patient’s name. Patient identification must be limited to the patient’s Medical Record Number.

For external e-mails; Use your hospital e-mail account to ensure your e-mail content is encrypted during transmission via the internet.

To force encryption of any e-mail, place the word secure as the first word in the subject line of your mail when using your hospital e-mail account. ** Note: Remember to check the e-mail address you select (from the name list) before sending your e-mail. This will PREVENT sending your message to the wrong person and preventing an unauthorized disclosure of PHI breach. Reference: HIPAA 45 CFR 164.508 and 164.312 (a) (2) (iv) and (e) (2) (ii) HITECH Act 13402 (h) (1) (A) and (B) and (h) (2) Policy # 1410.03 “Confidentiality and Protected Health Information (PHI)

HIPAA Tip

Medical Executive Committee Approvals

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Items approved at the last Medical Executive Committee meeting can be viewed by using this website link and selecting the particular month: http://www.torrancememorial.org/For_Physicians/Medical_Staff/MEC_Approval.aspx . If you have any questions, please contact the Medical Staff Services Department at (310) 517-4616.

Save the Date General Staff Meeting

November 5, 2014 12:00 Noon

Hoffman Health Conference Center

Monday Tuesday Wednesday Thursday Friday

1 7:00a CV Review Conf……….WT-D

2 7:00a Breast Tumor Board..WT-Aud 7:45a Lung/Thoracic Tumor Board…………...…...WT-Aud 12:30p Medical Staff PI……..….WT-D

3  7:00a Surgery Dept……..WT-Aud 7:30a IRB…………………..WT-D

6 12:30p Cardiology………..…WT-D

7 8:00a TCU……………...….…..WT-B 12:30p Infection Control/P&T....WT-D

8 7:00a Anesthesia PI….… ..WT-Aud 7:00a CV Review Conf……….WT-D 12:30p Bylaws Committee…...HCC-3 12:30p CME Conference….HCC-1&2

9 7:00a Breast Tumor Board..WT-Aud 7:45a GI Tumor Board….....WT-Aud

10 7:00a CV Institute………..WT-C 12:30p Ophthalmology Surgery..……….....WT-B

13 12:30p Credentials……….....WT-C

14 5:00p Professional Relations...WT-C 6:00p Medical Executive……..WT-D

15 7:00a CV Review Conf……….WT-D 12:30p CME Conference….HCC-1&2

16 7:00a Breast Tumor Board..WT-Aud 7:45a Lung/Thoracic Tumor Board…………...…...WT-Aud 9:00a Emergency Dept……….WT-D 12:30p Pediatric Dept……….WT-Aud

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20 7:00a Cardiac PI……………WT-C 7:00a Quality & Patient Safety Committee…….……..WT-D 8:00a Vascular Surg Subc...WT-B 12:00p Burn & Wound Surg...WT-C

21 12:30p C-Section Ad-Hoc.…….WT-D

22 7:00a CV Review Conf……….WT-D 3:00p Ortho COE Hip & Knee..WT-C

23 7:00a Breast Tumor Board..WT-Aud 7:00a Surgery Advisory…...….WT-D 7:30a Family Practice Dept…..WT-B 7:45a Gen Tumor Board…..WT-Aud 12:30p Credentials……….….....WT-C 12:30p Health Info Mgmt……....WT-B

24 7:00a General Surg Subc..WT-C

27 12:30p Stroke Ad-Hoc….…...WT-D 4:00p Bariatric Surgery…....WT-C

28 7:00a Breast Program Subc....WT-B 8:00a Medicine PI………….....WT-E 12:30p OB/GYN Dept……….WT-Aud

29 7:00a CV Review Conf……….WT-D 12:00p Radiology Dept……......WT-D

30 7:00a Breast Tumor Board..WT-Aud 7:45a Gen Tumor Board…..WT-Aud

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CME CONFERENCES Wednesdays, 12:30 p.m. Hoffman Health Conference Center

Torrance Memorial Medical Center is accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA) to provide continuing medical education for physicians.

Torrance Memorial Medical Center designates this live activity for a maximum of 1 AMA PRA Category I creditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This credit may also be applied to the CMA Certification in Continuing Medical Education. For up-to-the-minute conference information call (310) 784-8776 or visit: http://www.torrancememorial.org/For_Physicians/Wednesday_CME_Conferences.aspx

Medical Staff Calendar October 2014

October 29, 2014 NO CONFERENCE

October 1, 2014 NO CONFERENCE

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October 8, 2014 “Autism Spectrum Disorders” Roger Light, Ph.D. UCLA School of Medicine Commercial Support: None

October 22, 2014 NO CONFERENCE

November 5, 2014 NO CONFERENCE

October 15, 2014 “Valley Fever” Theo Kirkland, M.D. University of California at San Diego School of Medicine

November 12, 2014 NO CONFERENCE

November 19, 2014 NO CONFERENCE

November 26, 2014 NO CONFERENCE

The Medical Staff Newsletter Progress Notes is published monthly for the Medical Staff of Torrance Memorial Medical Center. Thomas G. Simko, M.D. Chief of Staff Robin S. Camrin, CPMSM, CPCS Vice President, Medical Staff Services & Performance Improvement ANK-10/2014

Address Change Juliana Austin, M.D. Pediatrics Children’s Hospital Los Angeles 4650 Sunset Blvd., Ste. MS61 Los Angeles, CA 90027 Phone: (323) 361-4606 Fax: (323) 361-1350 Amy Bandy, D.O. Surgery 320 Superior Ave., Ste. 170 Newport Beach, CA 92663 Phone: (949) 574-0574 Fax: (949) 574-0573 Ricardo Huete, M.D. OB/GYN Torrance Memorial Physician Network - Carson 824 E. Carson St., Ste. 203 Carson, CA 90745 Phone: (310) 543-5448 Fax: (310) 316-5318 Jacob Khoubian, MD. Surgery Wolstan Eye Associates 23600 Telo Ave., Ste. 120 Torrance, CA 90505 Phone: (310) 543-4546 Fax: (310) 543-1519 Wayley Louie, M.D. Pediatrics Torrance Memorial Physician Network - Hermosa Beach 507 Pier Ave. Hermosa Beach, CA 90254 Phone: (310) 406-0827 Fax: (310) 406-8378 Mona Ramaney, M.D. OB/GYN 4201 Torrance Blvd., Ste. 745 Torrance, CA 90503 Phone: (310) 540-4060 Fax: (310) 540-4566 Ramin Roohipour, M.D. Surgery (No longer with Association of South Bay Surgeons) 20911 Earl St., Ste. 200 Torrance, CA 90503 Phone: (310) 214-3278 Fax: (917) 591-6575

Alexander Stein, M.D. Surgery 8635 W. 3rd Street, Ste. 865W Los Angeles, CA 90048 Phone: (310) 854-1904 Fax: (310) 854-6763 Rita Tenenbaum, M.D. Pediatrics Torrance Memorial Physician Net-work - Hermosa Beach 507 Pier Ave. Hermosa Beach, CA 90254 Phone: (310) 406-0827 Fax: (310) 406-8378 David Wallis, M.D. Family Practice Torrance Memorial Physician Network - Hermosa Beach 507 Pier Ave. Hermosa Beach, CA 90254 Phone: (310) 891-6708 Adam Weitzman, M.D. Anesthesia 2557 Pacific Coast Hwy., Ste. A Torrance, CA 90505 Phone: (310) 626-8037 Fax: (310) 626-8038

Phone/Fax Change Doron Kahana, M.D. Pediatrics Phone: (310) 542-7900 Fax: (866) 591-7297

Physician Roster Updates

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ProgressNotes Vol. 6 Issue 10 October 2014

ProgressNotesMONTHLY

MEDICAL

STAFF

NEWSLETTER

Medical Staff Services 3330 Lomita Boulevard Torrance, CA 90505 Phone: (310) 517-4616 Fax: (310) 784-8777 www.TorranceMemorial.org

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