REPORT TO THE COMMUNITY CONTENTS LEADERSHIP MESSAGE

Leadership Message 1

Patient Care 2 How can we improve more people’s lives? Research 12 This fundamental question drives virtually everything we do at Cedars-Sinai. Community 22 It’s what motivates one of our cancer researchers to drive to her lab on a Sunday morning to check on new results Education 28 from an experimental study. It’s why our pharmacists and nurses now regularly visit nine local skilled-nursing facilities to help coordinate care for patients recently discharged from Cedars-Sinai Medical Center. It’s why The Campaign one of our Heart Institute physicians developed an innovative educational partnership with local barbershops to for Cedars-Sinai 32 reduce high blood pressure among African-American men. The Numbers 38 We know that a key element in improving more people’s lives is increasing access to our care. And we’re doing this Where We Are 40 in myriad ways. Leadership 2017 44 To help meet the growing community demand for Cedars-Sinai services closer to home or work, we now have locations for primary, urgent and specialty care throughout Southern California. We also are affiliating and partnering with other healthcare organizations that share our commitment to excellence. Affordability is an important aspect of accessibility, so we are doing more than ever to increase our operational and clinical efficiency in ways that reduce our costs — and improve quality. In addition, our free and part-pay care for the uninsured, as well as innovative payment models with commercial health plans, helps more people access Cedars-Sinai.

Our biomedical research also increases access to the best healthcare, not only for those who receive innovative new treatments at a Cedars-Sinai facility but also for those around the nation and the world whose physicians can better treat them thanks to Cedars-Sinai research findings.

Accessibility also requires a robust supply of well-trained physicians, nurses, pharmacists, scientists, technologists and others. We contribute in this area as well, with one of the nation’s most highly regarded education programs, training physicians, nurses and others at all levels.

Last but not least is our dedication to community service, which has a growing impact on the lives of the most vulnerable Los Angeles residents. For example, our Community Clinic Initiative is strengthening the leadership and effectiveness of health clinics across Los Angeles that care for more than 750,000 underserved residents. A crucial element of our success in all these efforts is the strong support of our community and the many partnerships that enable us to accomplish so much together. Thank you for sharing our commitment to improving more people’s lives, every day.

MARC H. RAPAPORT THOMAS M. PRISELAC Chair, Board of Directors President and CEO

CEDARS-SINAI REPORT TO THE COMMUNITY 2018 1 PATIENT CARE QUALITY CARE CLOSER TO HOME

edars-Sinai continues expanding its urgent care, primary care and THE NUMBERS: advanced specialty services to reach more people throughout Southern California. Recent additions include a new urgent care facility in 50,446 C ADMISSIONS Silicon Beach. Located at Runway Playa Vista, the facility provides convenient access to same-day care, on-site lab and X-ray services, and highly trained teams in internal

medicine and pediatric care. 92,109 EMERGENCY VISITS “The urgent care and new offices are part of our ongoing efforts to bring our doctors closer to where our patients and 256,075 PATIENTS CARED FOR employees live and work,” says John Jenrette, MD, executive vice president BY CEDARS-SINAI of the Cedars-Sinai Medical Network. He notes that primary care physicians, MEDICAL NETWORK obstetricians and gynecologists, and pediatricians also offer services at Runway Playa Vista, making it convenient for area residents to access expert care. The 2,166 PHYSICIANS ON location serves such nearby communities as Culver City, Mar Vista, Marina del Rey, MEDICAL STAFF Playa del Rey and Westchester.

Cedars-Sinai’s recent growth includes bringing health services to the San Fernando 3,363 NURSES Valley, with an increasing number of Cedars-Sinai Medical Network primary care physicians opening offices in this region. The health system is also expanding its 2,650 cancer, imaging and radiation oncology services across the San Fernando Valley, VOLUNTEERS opening practices and offices that build on a growing network of cancer care locations in Beverly Hills, Santa Monica and West Los Angeles. New offices in Tarzana, Encino and West Hills now offer a range of cancer services, including imaging and medical oncology specialists.

ILLUSTRATIONS BY DAVIDE BONAZZI CEDARS-SINAI REPORT TO THE COMMUNITY 2018 3 PATIENT CARE

HEART CANCER PATIENT SAFETY

LIFESAVING TO MEND THE CANCER THERAPY LESS INVASIVE, PHARMACISTS SAFER ANTIBIOTIC CARDIAC TEST SMALLEST HEARTS GROWTH SAFER RADIATION PREVENT USE A 911 call is usually too late A new minimally invasive With the addition of a Of the over 700 newly READMISSIONS With the goal of ensuring when someone suffers a technique for repairing treatment center that diagnosed breast cancer As prescription drugs that patients receive no sudden cardiac arrest, an the most common cardiac offers state-of-the-art cases seen at Cedars-Sinai become more sophisticated more and no less antibiotic electrical disturbance that birth defect in extremely cancer therapies in a each year, approximately and the number of patients treatment than necessary, causes the heart to stop premature newborns can comfortable, convenient 500 women have early needing complicated Cedars-Sinai has expanded beating. The condition be performed safely with a location less than a mile stage invasive breast treatment regimens grows, the use of three-day NATIONAL LEADER is fatal in more than 90 high success rate in babies from the hospital campus, cancer. The Saul and Joyce the Cedars-Sinai Pharmacy electronic alerts to reassess IN ORTHOPEDICS percent of patients. But as small as 1.6 pounds, only Cedars-Sinai is expanding Brandman Breast Center — Services Department has these prescriptions. a new assessment tool a few days after birth. The its radiation oncology A Project of Women’s implemented rigorous Clinicians who order eflecting the growing role of orthopedics, developed at Cedars-Sinai catheter-based approach services. A collaboration Guild at the Samuel Oschin processes to prevent antibiotics are prompted on Cedars-Sinai has established a Department brings physicians closer to repairing patent ductus with Integrated Oncology Comprehensive Cancer medication errors while the third day of a patient’s Rof Orthopaedics (it was formerly part of the to predicting who is most arteriosus (PDA), commonly Network LLC, the 8,500- Institute is at the forefront patients are in the hospital — treatment to indicate Department of Surgery) and recruited prominent at risk — and gives them referred to as “a hole in square-foot center at of evaluating less invasive and after discharge. their plans to continue, orthopedic trauma surgeon Mark Vrahas, MD, to a chance to prescribe the heart,” was developed 8929 Wilshire Blvd. procedures to maximize Pharmacists are alerted discontinue or modify use serve as founding chair. Vrahas, who was recently preventive medication by an expert in catheter- in Beverly Hills offers quality of life and minimize when at-risk patients — of the drug. If treatment is named the Levin/Gordon Distinguished Chair in or implant a defibrillator. based cardiac interventions, Varian TrueBeam linear morbidity. Radiation therapy such as those with complex continued, the physician Orthopaedics in honor of Myles Cohen, MD, joined The research team, whose and a pediatric cardiac accelerator technology, is typically recommended conditions who take must document the Cedars-Sinai in 2016 from Harvard Medical School. findings were published in surgeon at the Guerin a radiotherapy system with breast conserving multiple medications — are reasons. Physicians also are Cedars-Sinai’s orthopedics program, which European Heart Journal, Family Congenital Heart that delivers fast cancer surgery but may expose admitted so they can review contacted by pharmacists consistently ranks among the nation’s best, has employed the 12-lead Program. Guided by treatments with pinpoint healthy organs such as medication histories and to discuss guidelines for experienced record clinical and academic growth electrocardiogram (EKG) — ultrasound waves, the precision while protecting the lung and heart to reconcile them with current therapy using antibiotics over the past several years. It recently integrated a widely available and physician guides a catheter nearby healthy tissue and unnecessary radiation. doctors’ orders. Pharmacists and other antimicrobials. many world-renowned sports medicine specialists inexpensive cardiac test — through a vein in the leg organs. The facility is Intraoperative radiotherapy also contact high-risk The alerts are part of an in the Cedars-Sinai Kerlan-Jobe Institute, which to assess patients’ risk. to the heart and closes staffed by Cedars-Sinai is a new technology that patients within 72 hours ongoing, system-wide has offices throughout Southern California. Its Using multiple EKG data the hole. The procedure physicians and employees allows delivery of a single after discharge. Based on Antimicrobial Stewardship doctors also serve as team physicians for many points to evaluate patients, can be performed at the and is fully integrated into concentrated dose of physician review, hospital Program aimed at reducing professional sports teams and athletes in the they found that those who bedside and takes only Cedars-Sinai’s medical radiation to the tumor readmission was avoided for antimicrobial resistance and region and nationwide. The department provides scored 4 or above on a scale a few minutes. If left records system. Lab tests, during a lumpectomy, while 40 percent of these patients increasing patient safety. patients with comprehensive orthopedic care from 0 to 6 have as much as untreated, PDA can cause X-rays and reports flow preserving surrounding as a result of post-discharge specializing in sports medicine, hand, shoulder 20 times the increased risk heart failure and lifelong seamlessly between the healthy tissue, including intervention to help them and upper extremity, hip and knee, foot and ankle, for sudden cardiac arrest as complications. Although center and the hospital. the lung and heart. This understand how to take trauma and fracture care, arthroscopic surgery, patients with lower scores. PDA usually is diagnosed at The new facility adds to helps to reduce side effects their medications safely. spine and pediatric orthopedics. birth, some older children a growing network of and treatment time. The and adults have the radiation oncology services technology may lead to ABOVE: Justin Saliman, MD, an expert at the Cedars-Sinai condition for years before that also includes Cedars- greater patient satisfaction Department of Orthopaedics, with a patient who underwent minimally invasive surgery to heal a painful symptoms are noticed and Sinai’s main hospital and reduced costs of condition of the hip joint diagnosed. campus and its affiliate The treatment. Angeles Clinic and Research Institute in Santa Monica.

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SURGERY WOMEN’S HEALTH TECHNOLOGY

TRANSGENDER SYNCHRONIZED LIVER TRANSPLANT WHAT MOMS WANT BEYOND LAUNCHPAD FOR COMMUNITY CARE KIDNEY SURGERIES MILESTONES More than 130 mothers, ‘BABY BLUES’ TECH INNOVATORS From gender-affirming Nearly 100,000 people The Liver Transplant doulas, midwives, nurses For 1 in 7 women who have Turning promising ideas into surgery to hormone are on the current national Program continues breaking and physicians discussed just given birth, postpartum breakthroughs for better management and mental kidney transplant waiting new ground in clinical the importance of shared depression can bring care and better health is health counseling, the new list, and 3,000 are added volume and outcomes. The decision making and on extreme feelings of the goal of the Cedars- Transgender Surgery and every month. An average program performed 87 understanding roles in sadness and anxiety that Sinai Accelerator Powered Health Program at Cedars- of 13 people a day die liver transplants in FY2017, childbirth during Cedars- last weeks or months if left by Techstars, an intensive GPS FOR SURGEONS Sinai offers comprehensive, waiting for a new kidney. its highest volume ever. In Sinai’s fourth annual Birth untreated. Following the three-month program interdisciplinary and These alarming numbers addition, patient and graft Community Day. Cedars- 2014 implementation of that provides mentoring edars-Sinai neurosurgeons are the first individualized services. prompted a 42-year-old survival — the two most Sinai is at the forefront one of the first hospital- and other support for in California to use an advanced, high- The program is staffed by filmmaker to donate his common benchmarks for of patient-centered labor wide depression screening technology innovators. Cdefinition imaging and navigation system specialists dedicated to kidney to a stranger in need. transplant programs — and delivery practices programs in the U.S., Startups nurtured through that displays details undetectable by the naked helping members of the The donation led to six both exceeded 90 percent. that honor women’s Cedars-Sinai has introduced this program, now in its third eye or MRI. The device, called BrightMatter transgender community at synchronized surgeries that The increase in transplant childbirth preferences while a program to identify class, have the potential Guide, works like GPS, helping surgeons find every stage of their journeys. netted three healthy kidneys volume is partly a result still making safety and new moms who suffer to dramatically improve safer pathways to reach and remove tumors. In addition to providing and created a three-way, of a collaboration among evidence-based care top from this mood disorder. and streamline healthcare Until now, neurosurgeons have relied largely on clinical care, the team is living donor transplant the transplant, surgical priorities. Maternal Fetal Through the Cedars-Sinai delivery. WELL Health, a the flat, two-dimensional renderings of the brain committed to conducting chain — the longest to date intensive care unit and Medicine also launched a Postpartum Depression company fostered by the produced by conventional MRI scans. The new research to develop better at Cedars-Sinai. The chain transfer center teams that national study to help fill Screening, Education and first Accelerator class, rolled device provides real-time, brightly colored 3-D surgical techniques and involved three altruistic aims to optimize care for a gap in data about what Referral Program, these out its text-messaging app images that guide surgeons through the brain’s gender-affirming options kidney donors and three critically ill liver patients. childbirth patients want women receive support and is live in 135 clinics and tiny neural connections while avoiding healthy for transgender patients. patients who received The transplant group takes and need. The findings will from a social worker and, doctors’ offices at Cedars- tissue. “This technology allows us to more safely Cedars-Sinai is one of only lifesaving transplants. The challenges seen in the clinic be used to inform hospitals if necessary, a psychiatric Sinai, along with 48 other enter the brain without disturbing the important two academic medical chain was made possible by to the laboratory to pursue of what matters most to consultation as well as providers. The app helps pathways connecting the brain’s critical areas centers in the Western groundbreaking advances discoveries for improving women and to improve referrals for follow-up care. administrators and care of operation,” says Keith L. Black, chair of the U.S. offering genital in transplant immunology treatment outcomes. patient satisfaction. The program is partnering coordinators reach patients Cedars-Sinai Department of Neurosurgery, reassignment surgery, at Cedars-Sinai that greatly For example, they are with local organization between visits. Another director of the Maxine Dunitz Neurosurgical and has treated patients reduce the risk that a studying mechanisms Maternal Mental Health company that went through Institute, and the Ruth and Lawrence Harvey from across the nation as patient’s body will reject a of immunosuppression NOW to train nurses so they the Accelerator program, Chair in Neuroscience. An estimated 62,000 well as Canada, Asia and living donor organ. and causes of fatty liver can educate moms about Deep 6 AI, is deploying its primary brain tumors and 150,000 metastatic Mexico. Few surgeons disease as well as new postpartum depression. artificial intelligence system brain tumors are diagnosed annually in the are trained to perform treatments for liver cancer across Cedars-Sinai to help United States. About one-third of the 600 brain gender-affirming surgery, that could increase access researchers find patients surgeries performed at Cedars-Sinai each year so Cedars-Sinai plays a key to transplants for these for clinical trials. Accelerator will use the new device. role in addressing the health patients. participants are selected needs of the underserved in a competitive process ABOVE: Neurosurgeons at Cedars-Sinai are the first to U.S. transgender population, that attracts hundreds of employ BrightMatter Guide, which cuts surgery time and improves patient outcomes. which is estimated to startups around the globe. be as large as 1.4 million adults, including 218,000 in California.

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TECHNOLOGY MORE

AWARDS AND RANKINGS APP FOR VIRTUAL REALITY ONE-STOP RAPID TRIAGE AFFILIATION EXPANDED APPLE WATCH RELIEF RECORD ACCESS SAVES LIVES BENEFITS PATIENTS ENDOSCOPY The measure of a health system’s success With a new update to its A deep dive into a calming Patients today often The creation of a Cedars- Cedars-Sinai and Torrance SERVICES is reflected in outstanding patient iOS mobile app, Cedars- virtual reality experience — receive care from multiple Sinai Pulmonary Embolism Memorial have announced Cedars-Sinai has opened satisfaction scores, increasing clinical Sinai has become one of such as swimming with healthcare organizations, Response Team (PERT) plans for a formal affiliation a new Endoscopy Center performance initiatives, excellent the nation’s first hospitals whales or flying over scenic with their medical gives patients quicker designed to strengthen to better serve a growing medical outcomes, ongoing research to offer technology Iceland in a helicopter — records stored in various access to highly specialized both organizations’ ability number of patients who and academic programs, and national compatible with Apple can significantly reduce pain electronic systems that care for a potentially to serve the community need gastrointestinal designations and awards. Highlights of Watch. The free app, which for hospitalized patients, a don’t communicate with deadly condition. With and to enhance access, endoscopy procedures, these rankings include: pairs with iPhones and recent Cedars-Sinai study each other. A solution to one phone call, physicians coordination and quality of including colonoscopies, can be found in the Apple shows. Fifty patients with this growing problem may whose patients have care for the public. Under upper esophageal ● For the 20th year in a row, Cedars-Sinai App Store by searching pain scores greater than come from a pilot study by intermediate- or high-risk the proposed affiliation, endoscopies and won the NRC Health Consumer Choice “Cedars-Sinai My CS-Link,” 3 on a scale of 10 tried researchers at Cedars-Sinai pulmonary embolisms each institution will retain sigmoidoscopies. The Award for providing the highest-quality includes many convenient virtual reality therapy, Enterprise Information can reach experts in its respective board of 5,801-square-foot center, medical care in the Los Angeles region, features such as hospital while another 50 patients Services. Funded with multiple disciplines for directors and continue to located at the southwest based on a survey of area households. and urgent care locations, with similar pain levels nearly $1 million from consultations. PERT operate separately but corner of Wilshire Boulevard maps and directions to the watched a standard nature the U.S. Department of includes leading pulmonary, will affiliate under a new and Le Doux Road, features ● Cedars-Sinai is ranked nationally in nearest location, and the video. Those who wore Commerce, the study critical care, cardiology, parent organization with three procedure rooms, 12 specialties and was ranked No. 11 ability to call a recently virtual reality goggles focuses on software that interventional cardiology a new board of directors, a physician workroom, a of more than 4,500 hospitals in the searched doctor directly reported a 24 percent drop would make it possible to and cardiothoracic surgery to be called Cedars-Sinai 10-bay pre-procedure/ nation in U.S. News & World Report’s from the app. The goal is in pain scores, compared log in once to gain secure specialists who provide Health System. Both post-procedure area, a Best Hospitals 2017–18, placing it among to make health information to 13.2 percent for the access to medical records rapid triage and state-of- entities will continue their nurses’ station and a consult a select group of Honor Roll hospitals. accessible to patients video group. The study, at multiple institutions. The the-art care in a field in longstanding partnerships room. Clinicians can see from any location. The published online by JMIR current system is especially which treatment options with local community 30 to 50 patients a day at ● Cedars-Sinai garnered a fourth health system currently Mental Health, concluded vexing for physicians have grown exponentially health organizations. The the new center, which is consecutive Magnet designation for is preparing to launch that virtual reality hijacks caring for patients who are in recent years. The team proposed affiliation will focus accredited by the Centers nursing excellence from the American Android- and iPad- the senses in a positive transferred to rehabilitation is available around the on new opportunities for for Medicare & Medicaid Nurses Credentialing Center, becoming compatible apps. way, making it difficult or other post-acute-care clock to offer rapid clinical coordination of care between Services and the the hospital with the longest-running or impossible to perceive facilities among affiliated evaluations and treatment Cedars-Sinai and Torrance Accreditation Association Magnet designation in California. other stimuli — including institutions, so the study will recommendations. In Memorial, and joint programs for Ambulatory Health pain. Next, researchers seek to enroll Cedars-Sinai addition to inpatient to provide more people with Care. The facility contracts ● For the eighth consecutive year, will conduct a larger study physicians who regularly treatment, they guide access to medical services, with most major insurance Cedars-Sinai has earned the highest to measure the impact of see patients at the physicians in follow- clinical trials and the latest carriers. ranking from the federal government for virtual reality on use of pain California Rehabilitation up management and developments in research. low post-hospitalization mortality based medications and length of Institute, a Century City monitoring that is crucial for Over the past several years, on three conditions: pneumonia, heart hospital stay. facility jointly run by keeping patients safe after Cedars-Sinai and Torrance failure and acute myocardial infarction. Cedars-Sinai, UCLA Health they leave the hospital. Memorial have collaborated System and Select Medical. on a variety of projects, and established a “telestroke program” to more quickly diagnose and treat stroke patients.

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MORE

AWARDS AND RANKINGS PATH TO ORBIT OF CARE INFECTION FIGHT DEPRESSION BLOODMOBILE’S BODY, MIND EXCELLENCE A new multidisciplinary EXPANDS SAFETY NET VITAL MISSION AND SOUL ● The health system received a 2016 The Department of clinic at Cedars-Sinai The battleground for A study showing that Reaching out to the The Spiritual Care Bernard A. Birnbaum, MD, Quality Pathology and Laboratory provides highly specialized fighting infections has 1 in 3 hospitalized patients community through the Department, an integral Leadership Award by ranking eighth out Medicine delivers healthcare care to patients with thyroid been extended to eight experiences symptoms of Mobile Blood Collection part of the interdisciplinary of more than 100 academic medical services to a large eye disease (TED, or Graves’ local nursing homes where depression calls attention Program brings in healthcare team at Cedars- centers participating in a study by population throughout disease) and other complex Cedars-Sinai works to to the importance of potentially lifesaving Sinai, received a record Vizient Inc., a healthcare performance- Southern California in both orbital conditions such as ensure patients receive the screening to improve donations that are critical to number of referrals over the improvement company. inpatient and outpatient cancer and trauma. The appropriate antibiotic at outcomes. Cedars-Sinai transplant programs, cancer past year — an average of clinics. The department Orbital and Thyroid Eye the right time. The program investigators analyzed therapy, the Neonatal more than 1,200 a month. ● Cedars-Sinai’s Department of Pathology performs more than 5 million Disease program offers aims to prevent infections, 20 studies of hospital Intensive Care Unit, The department expanded and Laboratory Medicine was named tests annually and receives a team of specialists hospital readmissions and depression screenings that obstetrics, general medicine its GRACE support program first runner-up for lab of the year by the more than 287,000 outreach that includes surgeons, the spread of drug-resistant look for symptoms such as and cardiac surgery, among for cancer patients, while prominent national publication Medical requisitions. Recent changes orthoptists, neuro- bacteria. Improper use of feeling down or hopeless, other areas. The mobile its Jewish Expectant Parent Laboratory Observer. were made to increase ophthalmologists, dry eye antibiotics is a national having little interest or program is the main reason workshop remained full patient comfort and clinical specialists, endocrinologists problem, and the Centers pleasure in doing things, Cedars-Sinai is able to every month. Religious ● Cedars-Sinai was named one of the outcomes, including: and rheumatologists. One in for Disease Control and and experiencing significant maintain its own large observances at Cedars-Sinai best places to work in information Testing for parathyroid 100 people will be affected Prevention estimates that sleep and appetite changes. blood supply rather than also were well-attended, technology (IT) in an annual list published hormones, which helped by thyroid eye disease, an more than 2 million illnesses The findings, published being entirely dependent with more than 600 people by Computerworld, a national digital reduce the time patients autoimmune condition in and 23,000 deaths each in the Journal of Hospital on outside sources. Blood participating in Yom Kippur magazine for IT and business technology are kept under anesthesia which immune cells attack year are related to antibiotic Medicine, show that these drives are held regularly in services and more than professionals. This is the ninth consecutive by 60 percent; the the thyroid gland, which resistance. Since 2015, patients are less likely to communities throughout 1,000 receiving ashes on year Cedars-Sinai has received the honor. introduction of an algorithm responds by secreting Cedars-Sinai has seen a take their medications the Southland, including Ash Wednesday. About 300 designed to minimize an excess amount of 20 percent reduction in the and keep up with their Anaheim, Long Beach, people attended the annual ● The Department of Neurology was unnecessary urine cultures thyroid hormone. Patients number of days patients outpatient appointments, Palmdale, Pomona and San Christmas concert, and designated as an MDA Care Center by the by a third, which in turn experience symptoms are treated with antibiotics which could delay recovery, Bernardino. The Staples more than 100 participated Muscular Dystrophy Association, a leading decreased inappropriate such as severe swelling at three of the nursing lengthen hospital stays and Center hosted recent drives in the Ramadan iftar meal. organization in the fight to cure muscle- use of antibiotics; and and bulging eyes, and the homes reporting data, increase the risk of hospital thanks to a partnership With the philosophy that debilitating diseases. autoverification in the disease can lead to loss and a 41 percent reduction readmissions. Cedars- with the Los Angeles healing involves the whole ER Lab, which reduced of vision. The program in the number of days Sinai routinely screens all Clippers. The program’s two person — body, mind and ● For the fifth year in a row, Cedars-Sinai turnaround times for will lead research efforts patients are treated with hospitalized adult patients “bloodmobiles” showed off soul — the Spiritual Care was included on the 2017 Most Wired patients in need of on promising therapeutic fluoroquinolone, a group for depression through a new look — a redesigned Department supports Hospitals and Health Systems list, emergency warfarin by agents that can interrupt of antibiotics that can have interviews conducted by exterior to mark the mobile patients and families in published annually by Hospitals & Health more than 20 percent. Last the disease process. serious side effects and nurses within 24 hours program’s 10th anniversary. spiritual and emotional Networks magazine. year, the U.S. Department can promote antibiotic of admission. Patients Plans are underway to add a distress. The chaplains of Health and Human resistance. who screen positive for third bus to the fleet. represent a broad array of Services tapped Cedars- depressive symptoms religious faiths and cultural Sinai to serve as a regional receive interventions from backgrounds. treatment center, which is their admitting physician, part of a national network to social worker and psychiatry receive patients with highly team. communicable diseases.

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edars-Sinai is leading a revolution in healthcare by translating genetic THE NUMBERS: discoveries into therapies geared to each patient’s individual needs and MORE THAN biology. Since debuting in 2016, Cedars-Sinai Precision Health, under C 900 ACTIVE the direction of Dermot McGovern MD, PhD, the Joshua L. and Linda Z. Greer Chair in RESEARCH PROJECTS Inflammatory Bowel Disease Genetics, has launched an array of projects using big data, digital technology and other advanced methods to promote care that is as personalized as it 6 NEW ENDOWED is patient-centric. Cedars-Sinai has been successful in receiving funding from California’s CHAIRS and President Obama’s initiatives on precision health or personalized medicine. The initiative joins scientists and clinicians with industry 52 NEW partners to create solutions that not only react to disease but FACULTY MEMBERS also might predict dangers so they can be prevented entirely. 74% INCREASE For example, a remote-monitoring system was designed at Cedars-Sinai to accurately IN NATIONAL INSTITUTES OF forecast cardiovascular conditions. Patients will wear a specialized watch paired to a HEALTH AWARDS smartphone or computer that measures activity, sleep, heart rate and stress levels, and MORE THAN self-report anxiety, depression and other health data. By integrating “big data” into

patients’ medical records, investigators can seek signals that predict who is at risk for 2,500 PUBLICATIONS a heart attack or stroke.

Other projects that are part of Cedars-Sinai Precision Health include predicting 504 developmental problems in children; finding biomarkers to anticipate individuals’ ACTIVE CLINICAL responses to rectal cancer therapies; identifying novel therapeutics to help overcome TRIALS chemo-resistant ovarian cancer; seeking better ways to detect prostate cancer; testing

the effectiveness of radiation and chemotherapy by measuring how quickly tumors $28.1 can repair the damage such treatments do to the DNA mutations driving cancer; and million centralizing a proteomic library to enhance the capability for, and cost-effectiveness TECHNOLOGY TRANSFER REVENUE of, biomarker discovery. These and other interdisciplinary investigations mark a new dawn in scientific endeavors in which the goal is to match the right treatment to the 82 INVENTION right patient at the right time for the best possible outcomes. DISCLOSURES

CEDARS-SINAI REPORT TO THE COMMUNITY 2018 13 RESEARCH

NEUROSCIENCES DIGESTIVE DISEASES

BRAIN CANCER DISH IT OUT MEMORY LANE ANOTHER BLOW SILENT KILLER GROUNDBREAKING GENE IDENTIFIED Cedars-Sinai scientists Before scientists can TO BRAIN INJURIES The rising epidemic of STUDY CONCLUDES A stem cell-regulating assembled a “disease in a address the question of Two studies led by nonalcoholic fatty liver The National Institutes gene that strongly affects dish” model that pinpoints how we store memories, Cedars-Sinai investigators disease is expected to of Health awarded the survival rates of brain how a defect in the blood- they need to know which examined whether a series eclipse hepatitis C as the $10 million to Cedars- cancer patients has been brain barrier can produce parts of the brain are of blows to the head can leading cause of liver Sinai gastroenterology identified by Cedars- Allan-Herndon-Dudley involved. Cedars-Sinai lead to amyotrophic lateral transplants by 2020. An investigators for a project Sinai investigators. Their syndrome, a rare and investigators recently made sclerosis (ALS). Researchers especially dangerous form is that will cap off the findings potentially could incurable psychomotor an unexpected discovery focused on examining such nonalcoholic steatohepatitis longest-ever study into the enable physicians to better disorder. The findings about a type of brain cell, connections by using rats (NASH), which afflicts genetic and immunological predict the prognosis of point to a path for treating called a persistently active engineered with a genetic nearly 16 million Americans. causes of inflammatory PROSTATE PROSPECTS patients with brain tumors this syndrome and hold neuron, that is critical to mutation associated with NASH is called a “silent bowel disease (IBD). and develop personalized promise for analyzing other supporting short-term ALS in humans. One study killer” for its lack of The interdisciplinary new way of using genetic data to treatments that save more neurological conditions memory. Results indicate found that a moderate- symptoms while it scars research, which began in identify which patients are most likely lives. The team spent three such as Alzheimer’s and that this specific neuron to-severe, single-episode the liver and develops into 1992, revealed that IBD Ato develop aggressive forms of prostate years analyzing the genetic Huntington’s disease. remains active for several brain injury did not cirrhosis — or even liver is actually a spectrum of cancer — even if their tumors initially seem makeup of more than 4,000 The dish model showed seconds when a person is hasten the onset of ALS. cancer. A pioneer in tackling chronic illnesses that causes to pose lower risk — has been developed by brain tumors to better that the thyroid hormone, required to memorize an A second study, however, these conditions, Cedars- painful inflammation of the Cedars-Sinai scientists. Their findings divide understand how glioma which is critical to object or image and recall revealed that recurrent, Sinai’s Fatty Liver Disease intestines. Crohn’s syndrome prostate tumors into three subtypes based on cancer stem cells reproduce neuron development, it later. The investigators mild injuries to both sides Program is engaged in a and ulcerative colitis are gene-activation pathways. Published in Cancer and how they influence wasn’t reaching the found persistently active of the brain — like those double-blind trial of a drug the most common forms. Research, this is the first large-scale study to patient survival. The brain. The hormone neurons in the medial seen in humans who suffer that targets NASH-caused The study also explored link clinical outcomes to subtypes based on the process led to pinpointing requires a biomolecule frontal lobe and were repeated concussions — fibrosis. The program also how the immune system processes by which genes are turned on and off ZEB1 as a gene that for transportation across surprised to also find them brought on earlier ALS plans to launch a clinical trial and fungal communities in in cancer cells. The method may help physicians regulates tumor growth. the blood-brain barrier. in the medial temporal development in those with of S-adenosylmethionine the digestive tract interact prescribe the most effective treatments for each The analysis suggests that Due to a gene mutation lobe. Until now, the medial the predisposing mutation. (SAM-e), which is used in to affect the disease. This patient based on how genes are activated in the patients born without the in Allan-Herndon-Dudley temporal lobe was thought ALS damages motor numerous countries to treat wealth of new information individual tumor. Another advantage is that the gene — or in whom it has patients, not enough of the to be involved only in the neurons, leading to muscle liver disease. SAM-e occurs will facilitate more precise new subtyping can be performed on tumor cells become less powerful biomolecule is in place to formation of new long-term atrophy and paralysis. naturally in the body, and diagnoses and novel circulating in the blood, which could potentially with age — tend to have do the job. The blood-brain memories. The findings Patients rarely live more low levels have been shown therapies tailored to the improve real-time monitoring during treatment. lower survival rates. The barrier protects the brain show that both areas of than five years after onset. to increase vulnerability biological makeup of each Prostate cancer is the second most common investigators also note that from toxins circulating in the brain are essential for This research provides a to liver conditions. patient. cancer in men in the U.S., affecting about 1 in 7 certain chemotherapies are the body’s blood system, maintaining short-term deeper understanding of The ultimate aim is to and causing nearly 27,000 deaths annually. Most ineffective in those lacking but defects can block the memory and rely on the the effects of head injuries prevent the need for liver tumors grow slowly and are not life-threatening, the gene, so different biomolecules needed for ongoing activity of these on professional athletes, transplants. but certain types of prostate cancer can spread treatments are required. healthy brain development. neurons for memorization. military personnel and to other organs and be fatal. others who are predisposed to ALS and other ABOVE: Prostate cancer researcher Sungyong You, PhD neurodegenerative diseases.

14 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 15 RESEARCH

DIGESTIVE DISEASES HEART CANCER

IBD IN AFRICAN- I ♥ HEALTH YOUNG HEARTS OPEN-HEART THYROID WHERE AMERICANS INSURANCE AT RISK SURGERY 2.0 SURVEILLANCE THERE’S SMOKE Inflammatory bowel Research led by Cedars- The National Institutes of Open-heart surgery is A clinical trial that could Smoking damages disease (IBD) is steadily Sinai shows that health Health awarded five-year a lifesaving procedure significantly change the lungs and also can on the rise among African- insurance cuts down on funding to a Cedars- commonly performed treatment for lower-risk cause pancreatic cancer, Americans. Cedars-Sinai is cardiac arrest, a condition Sinai study that seeks to to replace failing hearts, thyroid cancers is being according to a study led by partnering in the first-ever that kills 90 percent of its advance understanding of bypass clogged arteries conducted at Cedars- Cedars-Sinai. Investigators genome-wide association victims. Published in the a potential cardiovascular and repair leaky valves. Sinai. The study, the first developed mouse models DEADLY BACTERIA study of the condition. The Journal of the American disease risk factor in young While most patients recover of its kind on the West that showed precursors of TURNED GOOD research includes 2,345 Heart Association, the study women. Heart disease rates fully, some suffer long-term Coast, assesses whether pancreatic adenocarcinoma, African-Americans who found that sudden cardiac in the U.S. are dropping effects — or fatal heart active surveillance — an the condition’s most n a multinational study, Cedars-Sinai have IBD and 5,002 who arrest decreased by 17 in every population failure — from stress caused alternative treatment common type. When investigators helped identify an experimental do not. Imaging identified percent among previously except this group. The by the operation. Surgeons plan for less aggressive exposed to cigarette smoke, Itreatment that uses a potentially deadly two locations of genes uninsured adults who study hypothesizes that use a cardiopulmonary cancers — is as effective the mice’s cancerous cells bacteria as a lifesaving treatment for kidney on chromosomes that gained coverage through premenopausal women bypass machine to perform as immediate surgery. grew and multiplied. The transplant patients. They found that treating were uniquely associated the Affordable Care Act. with an estrogen-lacking the heart’s functions while Using active surveillance team then found that patients with the bacteria-derived drug before with ulcerative colitis — The research focused on condition are at increased it is not beating during a to monitor thyroid cancer smoke activated the protein transplantation significantly reduced — and in which, along with Crohn’s adults over 45, since risk and accelerated risk of procedure, but because the is modeled after a similar histone deacetylase-3, most cases eliminated — antibodies that can syndrome, is one of the increases with age. The cardiovascular disease. blood supply to the heart observational method that leading the tumor cells cause rejection or failure of new organs. These disease’s main types. IBD difference occurred in ages The condition is due to is interrupted, cardiac cells is becoming increasingly to produce IL-6, another antibodies, human leukocyte antigens (HLA), are affects more than 3 million 45–64, while for people stress, under-eating and can be injured. Scientists common in the treatment protein, which can alter naturally present as an immune system defense people in the U.S., with over 65 — who tend to over-exercising, which at the Cedars-Sinai Heart of low-risk prostate cancer. immune cells to promote against bacteria, viruses and other potentially symptoms that include be insured — incidence can cause estrogen levels Institute examined damaged The American Thyroid cancer instead of fighting harmful invaders, but also can attack a newly abdominal cramps, blocked remained the same. The to drop so low that some cells in tissue samples taken Association has released it. Fortunately, the research donated organ. Rejection risks rise dramatically bowels, fever, extreme study was conducted in women’s ovaries shut off from patients before and new guidelines suggesting also points to a potential for those with high exposure to foreign HLA — weight loss and anemia. collaboration with Oregon and menstruation ceases. after surgery. Their work that this approach is an treatment already approved such as through blood transfusions, pregnancy Although treatments offer Health & Science University. Previous studies of this demonstrates for the first appropriate option for small, by the Food and Drug or a previous transplant — triggering the some relief, there is no While larger studies among premenopausal state time in human hearts that low-risk thyroid cancers. Administration. When the immune system to be hypervigilant to invaders. cure. However, the genetic more diverse groups of showed that it can result in cardiac muscle cells react to The Cedars-Sinai trial scientists administered These antibodies persist over a patient’s lifetime, discoveries yielded by patients need to confirm conditions such as early- this type of injury by both includes physical exams, the drug suberoylanilide causing the body to perceive a newly donated this and other projects the findings, they could onset osteoporosis and an destroying and developing blood tests and ultrasounds hydroxamic acid to the organ as a threat and then attack it. The study, may open pathways to have major public health altered immune response. new mitochondria. every six to 12 months. mice, it reversed the effects which involved two coordinated investigations new therapies and more implications, as more than The study’s aim is to reverse Patients can choose to stop of smoking, allowed the and 25 patients treated in the U.S. and Sweden, personalized approaches to 350,000 out-of-hospital these concerning symptoms surveillance at any time immune cells to keep aims to overcome this overwhelming obstacle aid against IBD. cardiac arrests occur every with a simple estrogen to undergo surgery, and their original anticancer to successful transplants. Twenty-four of the year in the U.S. patch. surgery is recommended if function and stopped the patients were transplanted successfully after the tumor grows over time. development of pancreatic receiving the therapy. cancer.

ABOVE: A potentially deadly bacteria is harnessed into a lifesaving therapy for kidney transplant patients in an experimental treatment developed by Cedars-Sinai investigators.

16 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 17 RESEARCH

CANCER WOMEN’S HEALTH

MELANOMA CANCER’S TINY CANCER BREAST CANCER PRETERM PERIL OF HEARTS AND REVISITED COMPLEXITY KILLER TRIPLE PLAY Pregnant women who HORMONES Patients who receive IDENTIFIED A tiny drug-delivery system Triple negative breast experience spontaneous An imaging study by standard surgical treatment A study led by Cedars-Sinai engineered by Cedars-Sinai cancer (TNBC) is one of the preterm delivery (sPTD) investigators at Cedars- for melanoma that has investigators dramatically scientists could potentially most aggressive and deadly may face heightened Sinai suggests that women spread to one or more key illustrates the complexity prevent drug resistance types of breast cancer. It danger of cardiovascular using hormone replacement lymph nodes do not live of cancer by identifying and retard the recurrence does not generally respond disease, according to a therapy to relieve longer than those who more than 2,000 genetic of glioblastoma multiforme, to common treatments study of preterm delivery menopause symptoms forego such procedures, mutations in tissue samples the most common and and, unlike other breast and vascular dysfunction face a lower risk of death according to research of esophageal tumors. The aggressive form of brain cancer types, frequently at Cedars-Sinai. The study and show lower levels of GAME ON, BLOOD PRESSURE conducted by Cedars-Sinai findings reveal that even cancer. Even with maximum metastasizes to the brain. examined 20 women atherosclerosis — plaque investigators in one of the different areas of individual treatment, the cancer Since each TNBC tumor with sPTD and 20 women buildup in the heart’s edars-Sinai researchers are envisioning largest-ever studies of tumors have various genetic usually recurs because is unique, a Cedars-Sinai who experienced normal arteries — compared to a new use for virtual reality: protecting the deadliest form of skin patterns. These results of its resistance to drugs research team is developing deliveries. Each woman women who do not use Cpeople from high blood pressure. cancer. Their findings report help explain why it is so and radiation. In the study, targeted therapies for was examined 24–72 hours hormone therapy. Hormone Because African-Americans are especially at risk, that immediately removing difficult to battle cancer by researchers synthesized a TNBC by probing isolated after delivery to measure replacement therapy has Cedars-Sinai teamed up with the Black Nurses and performing biopsies targeting a specific genetic nanodrug, a tiny particle live tumor cells to find vascular function or arterial long been controversial, as Association’s local Council of Black Nurses (CBN) on all lymph nodes located defect. Looking ahead, the combining a chemical differences they can exploit. stiffness. Also recorded studies associated it with to launch a feasibility study in West Adams, a near the original tumor investigators plan to apply cocktail of drugs that can The aim is to discover which were cholesterol levels and benefits but also risks that historically African-American neighborhood in does not result in increased their analytic techniques to be given by intravenous drugs can destroy patient- markers of inflammation include cancer, and women Los Angeles. Specifically, the aim was to reduce overall survival rates. The other cancers and explore injection and carried in specific cancer cells, and that indicate a higher and their doctors must people’s intake of salt, a culprit in the condition. study examined the most the significance of the the blood to target the which properties of a tumor cardiovascular hazard. weigh many factors when Sixty participants received Fitbits, digital blood important question facing genetic and epigenetic brain tumor. Mouse models cell can serve as predictors The study’s first phase deciding whether to use pressure cuffs, the MyFitnessPal app and virtual physicians and those newly changes identified in carried three defective for life-threatening showed that the women it. While this study did not reality goggles. They met weekly for dinner, diagnosed with the disease: the study. This work is human genes associated metastatic cancer. The with sPTD had higher answer all of the remaining health education and data collection from their Do patients who have fundamental to developing with this cancer, and their ultimate goal is to enhance vasodilation, meaning that questions, it involved a new devices, and had twice-weekly calls from melanoma cells in a limited effective, individualized survival rates doubled when cancer diagnostic tools their blood vessels were larger number of patients CBN nurses. Participants received exercise and number of lymph nodes therapies to combat the they were injected with the and develop personalized more dilated than the and a longer follow-up time nutrition tips, and learned how to interpret blood require extensive surgery drug resistance that many nanodrug. The particle is treatment options. The team control subjects’. In addition than most other studies, pressure and cholesterol numbers. During the to remove all the remaining cancer patients face during engineered to permeate also is exploring innovative to identifying women who and offers new evidence of virtual reality game component, the players flew nodes in that area of the the course of their disease. the walls of the tumor cells regenerative tissue are at increased risk of potential cardiovascular and through their own hearts, brains, kidneys and body? The results of the for maximum effectiveness engineering of the human cardiovascular disease, survival benefits. blood vessels in immersive 3-D to visualize the new research suggest that against tumor targets while mammary gland. the findings may increase damaging effects of salt on their bodies. They the answer is no. preserving surrounding understanding of the also could use virtual reality features to alleviate tissue. mechanisms responsible for stress — a factor that can contribute to high preterm delivery. blood pressure — by spending time at a virtual beach or listening to nature sounds.

ABOVE: A study at Holman United Methodist is testing whether education and digitally enhanced programming using virtual reality can be a treatment for lowering high blood pressure.

18 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 19 RESEARCH

WOMEN’S HEALTH MORE

FERTILE GROUND SCALE OF RECOVERY PF CHANGE MEND THE GAP GAINS IN PAIN SKIP YOUR A Cedars-Sinai study The Braden Scale A major cause of pulmonary An innovative technique To address the growing WHEATIES? conducted by investigators is a routine nursing fibrosis — which scars the that prompts bone to epidemic, Cedars-Sinai A protocol being in the Center for Fertility assessment to protect lungs, clogs breathing regrow was used by a researchers are studying developed by Cedars-Sinai and Reproductive Medicine patients from bedsores, and has no known cure — Cedars-Sinai-led team of the most effective ways investigators may help and the Department of but a multicenter study has been pinpointed by investigators to successfully for physicians to discuss determine the effects on Pediatrics found that headed by Cedars-Sinai Cedars-Sinai investigators. repair severe limb fractures. opioid use with chronic humans of chemicals called babies born through has uncovered a vital new They solved the longtime If found to be safe and pain patients, with an aim “endocrine disruptors” — infertility treatments are use for it: predicting how conundrum by revealing effective in humans, this of reducing the impact and uncover whether twice as likely to be born well patients will recover damage done to AEC2s, pioneering method — which of pain while curbing such chemical additives late preterm, at 34–36 after liver transplants. stem cells in adult lungs combines ultrasound, stem overuse of these addictive in breakfast cereals and BLOOD SUGAR REGULATORS weeks, and have a higher The scale rates patients that are essential to cell and gene therapies — drugs. The research team other everyday products admission rate to the based on their activity repairing and regenerating could eventually replace will include consumer are making people obese. hile cutting off specific nerves to Neonatal Intensive Care levels, mobility, nutrition epithelial cells. Epithelial grafting as a way to mend advocates, addiction Previous research has the kidney might seem destructive, Unit. They also tend to and other measures of cells keep airways open, but severely broken bones. specialists and primary care shown that the chemicals Wresearch at Cedars-Sinai has shown require longer hospital stays frailty. For the research, pulmonary fibrosis disrupts Current graft procedures providers who will compare examined in this study — it actually could improve insulin’s effectiveness and need more aggressive published in the journal them, causing fibrous tissue require implanting pieces the effectiveness of two butylhydroxytoluene in the liver and have a positive outcome for respiratory support, but Liver Transplantation, to build up in the lungs. from either the patient’s established communication (BHT), perfluoro-octanoic diabetic patients. The liver metabolizes and overall do well with the investigators reviewed 341 The study, published in or a donor’s bone into strategies to treat chronic acid and tributyltin — can produces glucose, or sugar, that the body uses treatments. The study medical records of patients Nature Medicine, found that the gaps left by the pain patients. In the study, upset hormone systems for energy. However, in people with diabetes, provided insights into how at Cedars-Sinai and the pulmonary fibrosis patients fracture. Surgeries to computer alerts will prompt in lab animals. This effort insulin secreted by the pancreas fails to normalize the underlying genetics of Oregon Health & Science had far fewer AEC2s, and remove bone implants doctors to speak with is the first to use human glucose production in the liver. The mechanism infertility — compared with University in Portland. They those remaining were less can lead to prolonged patients before renewing stem cells and tissues to that accounts for this failure has been a mystery, the fertility treatments — found that liver transplant able to regenerate. This pain and expensive, opioid prescriptions and to document how they may until now. The answer: The kidneys and the affect pregnancy outcomes. recipients with lower finding is a major step lengthy hospitalizations. share educational materials. disrupt hormones critical liver are communicating with each other to set Fortunately, fertility scores were more likely toward understanding and Additionally, grafts from Studies to limit opioid use to communication between glucose levels. Using animal models, researchers treatments have made to be nonambulatory at one day treating pulmonary donors may not integrate may rely on prescription the digestive system and cut the nerves to the kidneys that had become great strides in the past discharge, require physical fibrosis, which affects nearly or grow properly, causing claims data to gauge results, the brain. BHT produced insulin-resistant from being fed a high-fat diet. two decades. For example, rehabilitation and have 100,000 people nationally. the repair to fail. The new but this project also will use some of the strongest After the procedure, the livers had a healthy in vitro fertilization is more longer hospital stays The disease often is called technique could provide a patient feedback, which adverse effects. More response to insulin, effectively curing the animals likely to be successful, compared with transplant “idiopathic,” meaning much-needed alternative, may be key for devising research is needed, but the of insulin resistance — a prediabetic condition. and higher-order multiple patients who had higher “unknown,” because the since 2 million bone grafts successful chronic pain team’s chemical-evaluation Kidney function remained normal following births, such as triplets, are scores. These results cause usually escapes are performed worldwide management strategies. system may provide a the procedure. The researchers’ next step is to now rare, also leading to suggest that lower-scoring detection. Patients typically each year. cost-effective method to pinpoint the most effective method for surgically healthier pregnancies for patients should be put survive only three to five review the health effects of silencing nerves in human kidneys — then the mom and baby. on supervised exercise years after diagnosis. thousands of chemicals in team can begin investigating the procedure’s programs soon after their our environment. potential for treating patients with diabetes. transplants to improve physical function and ABOVE: Richard Bergman, PhD, director of the Cedars- preserve quality of life. Sinai Diabetes and Obesity Research Institute and the Alfred Jay Firestein Chair in Diabetes Research, with Malini Iyer, PhD

20 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 21 PARTNERSHIPS TO BETTER COMMUNITY SERVE THE NEEDY

isa Abdishoo, MD, and colleagues at the Los Angeles Christian Health THE NUMBERS: Centers’ (LACHC) Joshua House Clinic in downtown’s Skid Row care MORE THAN Ldeeply about their homeless patients, many of whom live in makeshift $797 tents just outside the clinic’s doors. As Abdishoo, the center’s president and CEO, and her team confront the growing need for health services in the area, they’ve million CONTRIBUTION FOR found a resource that bolsters their ability to meet these urgent challenges — the COMMUNITY BENEFIT Cedars-Sinai Community Clinic Initiative. PROVIDING COMMUNITY BENEFIT THROUGH The initiative was launched in 2015 to reduce health disparities for those most in

need by strengthening the leadership and effectiveness of clinics across Los Angeles. 5,500 TARGETED PROGRAMS “Cedars-Sinai worked hard to understand the biggest AND ACTIVITIES challenges clinics face today and designed an initiative MORE THAN Abdishoo says. that offers support where it is needed most,” 200,000 The initiative includes yearlong programs that focus on quality care, financial HEALTH EDUCATION benchmarking, data analysis and leadership development. Participants receive AND SERVICE ENCOUNTERS FOR THE training and coaching, undertake projects that tackle critical issues faced by their MOST UNDERSERVED clinics, and network with other clinic leaders to share ideas and resources. Clinic MEMBERS OF OUR COMMUNITY leaders who have participated in the ongoing program now are putting lessons into practice, using new strategies to increase access to care, boost patient satisfaction, improve the referral process, strengthen coordination of care, retain employees and manage health data more effectively, among other enhancements.

Participating clinics have the potential to reach as many as 750,000 residents. The 27 clinic leaders who recently graduated from the initiative’s Managing to Leading program are implementing some of the key personal takeaways, including stronger communication skills, and are staying in touch with fellow program participants so they can help each other in continuing to improve healthcare for the most vulnerable among us.

CEDARS-SINAI REPORT TO THE COMMUNITY 2018 23 COMMUNITY

COMMUNITY YOUTH EMPLOYMENT EDUCATION COACH FOR KIDS HEALTHY HABITS AND DEVELOPMENT

PEACE OF MIND HAPPI AGING PARTNERS IN TEAM PLAYERS FUN FITNESS BIG DREAMS Among the “regulars” Cedars-Sinai COACH for SERVING WATTS Cedars-Sinai Healthy Seventy-five Los Angeles It was an occasion to at Cedars-Sinai’s annual Kids® — a program of the South Los Angeles residents Habits teamed up with elementary school teachers celebrate the achievements Prostate Cancer Education Maxine Dunitz Children’s received free immunizations the Los Angeles Clippers are finding it easier to of more than 50 Fairfax and Screening Program Health Center — is and education on nutrition to promote exercise and make fitness fun for their High School students are a number of men at promoting healthy aging and dental health from healthy eating initiatives students after participating who were mentored by higher risk than the general through a partnership Cedars-Sinai COACH for at two elementary schools in a free, daylong physical Cedars-Sinai employees. A VITAL LINK TO HEALTHCARE population because they are with the UCLA Center for Kids® — a program of the in the Los Angeles Unified education training program The students at the Cedars- African-American or have Health Policy Research. Maxine Dunitz Children’s School District. Hundreds by Cedars-Sinai Healthy Sinai Youth Employment any low-income, uninsured Latino a family history of prostate Cedars-Sinai is one of eight Health Center — during of students at Mid-City’s Habits. The teachers, from and Development (YED) residents come back year after year for cancer. They learned from organizations selected to the Los Angeles Police Prescott School of Enriched 15 schools where Healthy program’s Health Careers Mthe free health screenings provided by Cedars-Sinai healthcare participate in the center’s Department Southeast Sciences and Carson-Gore Habits educators offer Academy Annual Showcase, hundreds of Cedars-Sinai staff during the annual professionals that regular initiative to increase the use Division’s National Night Academy of Environmental workshops on nutrition held at Cedars-Sinai in April, Telemundo 52-KVEA Health and Wellness Fair screenings can be the of preventive health services Out event. They also gave Studies participated in and fitness, worked up a were encouraged to dream at the Los Angeles Convention Center. A leading difference between life and by underserved Latino and back by participating in exercise and a flash mob sweat trying out activities big. A once-shy young partner for the past seven years, Cedars-Sinai death, so the men return to African-American adults age a Cedars-Sinai mobile dance led by the Healthy to introduce to their woman is heading toward performed 5,600 screenings at the 13th annual the Ambulatory Care Center 50 and older. The COACH blood-collection drive. Habits staff, joined by students. Each participating a career as an aeronautical daylong event, which drew an estimated 25,000 each year for the peace of for Kids team provides The annual block party on Clippers mascot Chuck the school received two engineer and astronaut — people in January 2017. Numerous attendees mind that any problems education, health screenings 108th Street in Watts offers Condor and two Clippers activity boxes — one for with hopes of going to had their previous year’s test results in hand will be caught early. They and referrals to parents, entertainment as well as Spirit dancers. Two Clippers kindergarten through Mars. Many others aim as they talked to physicians, nurses, dietitians, also recruit family members grandparents and other free services and education teammates played games third grade and another for futures in healthcare. pharmacists and others. Services included and friends to attend the caregivers as part of the to help build bridges with students at Mid‑City’s for fourth through sixth During the showcase, they screenings for heart disease and diabetes as well event, at which a team of Healthy Aging Partnerships between law enforcement Prescott School, while grades — filled with offered poster presentations as health education and referrals — with plenty Cedars-Sinai physicians in Prevention Initiative and the neighborhoods others joined the activities hundreds of ideas for group about experiences that give of Spanish-speaking healthcare providers and provides free clinical (HAPPI). Services include they serve. Cedars-Sinai’s at Carson-Gore. The players activities that develop age- them firsthand exposure to translators on hand to assist. Sherry Goldman, NP, exams and nurses perform free cholesterol screenings two fully equipped mobile spoke to students about appropriate locomotor skills careers such as cardiologist, of the Saul and Joyce Brandman Breast Center — tests for blood pressure, and flu and pneumococcal medical units are well- the importance of exercise such as running, galloping, nurse practitioner and A Project of Women’s Guild at the Samuel Oschin prostate-specific antigen, immunizations, plus known in this underserved and a nutritious diet. The skipping, jumping and pharmacist. The two-year Comprehensive Cancer Institute, led a team cholesterol, blood glucose referrals for free or low- area, as the COACH for Healthy Habits program hopping. In “Dragon’s Tail,” YED program provides paid that offered free clinical exams, education and and testosterone levels. cost breast cancer, cervical Kids team makes regular brings curricula on nutrition for example, children tuck part-time work, mentoring referrals for free or low-cost mammograms. Participants with test results cancer and colorectal stops in Watts and other and physical activity to strands of material into their and job-shadowing “Knowing the care we offered might be the only outside the norm receive cancer screenings. HAPPI South L.A. neighborhoods. 15 underserved elementary waistbands and chase each experiences, and classroom care they would receive for at least another year referrals for affordable services are offered on the Among those who stopped schools. Cedars-Sinai is the other. Those who lose their instruction for Fairfax High or longer, it warmed my heart to be able to give follow-up care. COACH mobile clinics and at by during the National official health partner of the “tail” go to a designated juniors and seniors. Many back,” she said. various community sites in Night Out event were police Los Angeles Clippers. area to do some jumping YED students become the South Los Angeles. officers who thanked the jacks before getting back in first in their families to go ABOVE: Every year, nearly 500 Cedars-Sinai clinicians staff the Telemundo 52-KVEA Health and Wellness Fair. team for their service to the game. to college. this community.

24 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 25 COMMUNITY

COMMUNITY GRANTS SHARE AND CARE MORE

STRONGER STOP ABUSE THE POWER OF STUDENTS PERFORM ATHLETIC SUPPORT BEAUTY FROM SAFETY NET With state and federal ACTS OF KINDNESS VIRTUAL SURGERY Student athletes at WITHIN As part of ongoing efforts funding for domestic For children struggling with The chance to step into the underserved public high Helping women in to strengthen the safety net violence programs trauma and growing up shoes of a brain surgeon schools in Los Angeles underserved communities for the neediest residents declining, a grant from in violent neighborhoods, is a sure way to capture learn how to prevent sports better understand their of Los Angeles, Cedars- Cedars-Sinai came at small acts of kindness can the attention of middle- injuries — and receive cardiovascular disease risk Sinai awarded $4.8 million a critical time for a Los make a big difference. This school students — and it immediate medical care is the focus of Beauty From in grants to programs Angeles LGBT Center idea drives the “Random could spark interest in a at no charge if they do get Within, a new community that provide physical program that helps gay Acts of Kindness” initiative future career. This is what hurt — through the Team education and screening and mental healthcare and transgender people recently introduced into Brainworks is all about. HEAL program sponsored program launched by the NEW DIGS FOR MOBILE CARE for homeless individuals, escape partner abuse, the curriculum of the For nearly 20 years, the by the Cedars-Sinai Barbra Streisand Women’s at-risk youth, immigrants get to LGBT-sensitive Cedars-Sinai Share and program has brought Kerlan-Jobe Institute. The Heart Center in partnership edars-Sinai COACH for Kids® mobile and other underserved shelters and rebuild Care art therapy program. students from local middle Team HEAL Foundation, with The Heart Truth, a medical units are a welcome sight at populations. This is the their lives. The center’s Recommendations schools to Cedars-Sinai which launched the program of the National Cschools, homeless shelters, public housing health system’s third STOP Domestic Violence have been integrated to gain a firsthand look at program in 1994 in response Heart, Lung, and Blood developments and health fairs around Los Angeles. round of grants to increase program offers lifelines to into weekly art therapy what neurosurgeons do. to budget cuts in school Institute. Over a four- Two new COACH for Kids mobile clinics recently financial, administrative and people who feel trapped in sessions for students in The most recent annual sports, provides certified month period, the initial went on the road, bringing quality medical care leadership effectiveness at abusive relationships. One 28 L.A. schools as well as event gave 135 students an athletic trainers at Banning, phase of the program to families in areas such as Pico-Union, Skid Row, local community clinics and transgender woman from into parent education and opportunity to use a new Carson, Crenshaw and was completed, with 400 South Los Angeles, Watts and Compton. Since 1994, mental health organizations. Guatemala found a way teacher training sessions. high-definition imaging Westchester high schools. women screened at seven COACH for Kids, part of the Maxine Dunitz Children’s The Cedars-Sinai Community out of a violent relationship For example, children device to perform simulated Its free services include community events, primarily Health Center, has provided healthcare services to Clinic Initiative invests after a doctor at the LGBT are encouraged to invite surgery and see inside strength training and in South and Central hundreds of thousands of children and their families in efforts to improve Center noticed bruises on someone playing alone the brains of humanlike conditioning, education Los Angeles. Free risk in Los Angeles County. The shiny, new, fully equipped quality of care, financial her body during a routine to join in their game, and simulators — which on injury prevention and assessments and screenings mobile vans each include two exam rooms, an benchmarking, data analysis medical exam. The STOP teachers are urged to tell have pulses and can eat, nutrition, treatment for to check blood pressure intake room, a dispensary for pharmaceuticals and and leadership at clinics Domestic Violence team their classes three things breathe, speak and blink. injuries, rehabilitation and cholesterol levels took a mini lab for immediate testing. The eye-catching across L.A. The grants also helped her get to a shelter they appreciate about In addition to interacting services and annual place in sites from churches exteriors feature colorful, child-friendly artwork by support 13 mental health and provided mental them. In addition, parents with patient simulators at physicals. Students and community halls to hair San Francisco artist Christian Robinson, who grew partner organizations health counseling and legal are asked to set aside a a virtual surgery station, also receive mentoring, salons. The events were up in Central Los Angeles. The COACH for Kids team that treat uninsured and support from professionals special weekly time for the students looked at scholarship opportunities organized in collaboration offers a wide range of free primary and preventive undocumented patients trained in LGBT domestic activities with their child. tumors under a microscope, and exposure to careers in with organizations such as care services to some of the city’s neediest who face a variety of violence issues. She now The goal is to create a learned about treatments health-related fields. the Los Angeles chapters neighborhoods, including physical examinations, mental health issues, has a steady job, is living more empathetic, nurturing for people with brain of the Hispanic Nurses immunizations, treatment for minor illnesses, substance use disorders with friends and is planning school environment, with tumors and heard a keynote Society and Black Nurses nutrition education, vision and dental screenings, and and other challenges. The to go to college to develop the same atmosphere presentation by a nationally Society, the Philippine referrals to low-cost clinics. organizations include the business skills. developed at home as well. recognized researcher. Nurses Association of Los Angeles LGBT Center, Southern California and the ABOVE: Longtime COACH for Kids driver Donald Amanecer Community Cedars-Sinai Telemundo Washington with one of the new mobile clinics, which he takes on the road to 20 areas throughout Los Angeles Counseling Services and Community Outreach Children’s Institute Inc. Program.

26 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 27 EDUCATION TRAINING DAYS

edars-Sinai is dedicated to training healthcare professionals to provide the THE NUMBERS: highest-quality, innovative care and to advance medicine through biomedical research. Through highly competitive residency and fellowship programs, 14 RESIDENCY C PROGRAMS a growing PhD program, specialized training for nurses and educational opportunities for medical staff, present and future clinicians and scientists enhance their skills and expertise. 31 GRADUATES IN Medical students completed nearly 850 rotations in 10 departments during FY2017. THE PhD PROGRAM IN BIOMEDICAL AND About 424 residents and fellows entered Cedars-Sinai’s TRANSLATIONAL renowned training programs — which span more than 85 SCIENCES AND 8 NEW STUDENTS ADMITTED specialty and subspecialty areas — gaining experience in IN 2016 research as well as patient care. More than 20 residents, fellows and young faculty entered the pioneering Clinical Scholars Program that, in just two 2 NEW MASTER’S years, teaches the skills to build successful futures in clinical science. PROGRAMS

Cedars-Sinai and its faculty also are committed to providing educational opportunities 85 FELLOWSHIP for aspiring young biomedical scientists. The Research Internship Program facilitates PROGRAMS these experiences with a structured and mentored curriculum that supports learning in basic, translational and/or clinical research. This year, 170 research interns, mostly 844 MEDICAL STUDENTS undergraduate, graduate and medical students from local and national universities, ON ROTATIONS IN were placed with 56 faculty in 12 departments. This includes 24 high school-aged 10 DEPARTMENTS participants comprising the second class of the Minors In Research initiative. Upon

completion of the internship, 10 research interns were hired as employees. 138 NURSING RESIDENTS Nearly 2,000 healthcare trainees and professionals practice procedures monthly in TRAINED the Women’s Guild Simulation Center for Advanced Clinical Skills. The 10,000-square- foot facility is fully accredited by the American College of Surgeons and the Society for Simulation in Healthcare. It replicates clinical and surgical settings with high-tech practice patients that mimic their real-life counterparts by simulating breathing, crying — and even giving birth.

CEDARS-SINAI REPORT TO THE COMMUNITY 2018 29 EDUCATION

GRADUATE NURSING RESEARCH EDUCATION EDUCATION EDUCATION FELLOWSHIPS VOLUNTEERS

MASTERY OF HEALTH FIRST-IN-KIND SPECIALTY RN POSTDOCS PIVOTAL FELLOWSHIPS FOR RETURN OF DELIVERY SCIENCE MS IN MRI WORKFORCE TO RESEARCH SPIRITUAL CARE PRE-HEALTHCARE The new master’s degree Cedars-Sinai continues The Geri and Richard Postdoctoral scientists, both Cedars-Sinai’s Spiritual Care VOLUNTEERS in Health Delivery Science to expand its graduate Brawerman Nursing Institute, in-house and visiting, make Department introduced Undergraduate and post- at Cedars-Sinai’s graduate school, introducing a created in 2002 to address critical contributions to a fellowship in Clinical baccalaureate students school trains students in the master’s degree in Magnetic the increasing demand Cedars-Sinai’s increasingly Pastoral Education (CPE) to interested in becoming methodology of delivering Resonance in Medicine, the for specialty nurses, robust research initiatives. provide advanced training physicians receive valuable valuable healthcare by first of its kind in the United continues its commitment The 144 members of the for theological students and hands-on experience TEEN DREAM improving quality while States. The newly accredited to quality education and Postdoctoral Scientist clergy from all faiths. The through the Cedars-Sinai reducing costs. The program focuses on how opportunities for Cedars- Program play important program is open to board- Pre-Healthcare Volunteer or the sixth straight year, curious teens program teaches skills that MRI is applied to biomedical Sinai’s nursing workforce. roles in the institution’s certified chaplains who have Program, which recently gained hands-on exposure to stem cell are critically important in research and medicine. In In FY2017, the institute commitment to expand completed their primary relaunched after a two-year Fscience during Research Week at the managing the complex two years of study, students provided clinical training the horizons of medical CPE training — at least hiatus. Student volunteers — Cedars-Sinai Board of Governors Regenerative healthcare marketplace, master the fundamentals for over 800 undergraduate knowledge — partnering 1,600 hours of interfaith who are all committed to Medicine Institute. During the summer, 19 which increasingly rewards of using MRI for state- and graduate nurses, with on active research projects, education in a clinical attending medical school — Southern California high school students medical providers for value of-the-art medicine, a 95 percent retention performing hands-on lab setting. The fellowship shadow physician-mentors conducted experiments side by side with of care. The curriculum becoming proficient in rate of all nurses and work and analysis, and offers two tracks. One is and observe patient care in scientist-mentors in the institute’s laboratories focuses on four core pillars: technical development, 99 percent for first-year providing lab training to Chaplaincy Specialization, clinics, patient rooms and at the Advanced Health Sciences Pavilion. data analytics, health research methods and nurses. From 2004 to 2017, graduate students. In return, a yearlong program operating rooms. They also They learned about lab safety, toured imaging informatics, healthcare clinical applications. the program increased they receive up to five years focused on a department attend executive leadership and research facilities, and attended lectures financing, and performance The coursework the number of nurses with of advanced training under of the student’s interest, meetings, grand rounds and by Cedars-Sinai experts on the front lines of measurement and includes completing an specialty certification from faculty members, with the such as palliative care, lectures. Participants further medical research. At the program’s conclusion, improvement. Students are individualized research 11 percent to 81 percent. goal of optimizing their oncology or outpatient care. explore the calling to study the students, working in teams, presented their paired with a research or project and a hands- Over the same time period, career prospects within Students pair with staff medicine and discover a research findings to members of the Cedars- operational team at Cedars- on internship led by the number of nurses with their unique interests. and a chaplain to provide deeper appreciation for the Sinai scientific community and fielded questions, Sinai and work directly on distinguished scientists baccalaureate and master’s Cedars-Sinai postdocs supervised spiritual care demanding requirements just like real investigators. The students were the front lines of healthcare and physicians. Graduates degrees increased from are encouraged to pursue to patients and families. of a busy physician. The drawn from the Cedars-Sinai Youth Employment delivery, with access to the are prepared to serve as 50 to 86 percent. Both careers in academia, The other is the Certified eight- to 10-week program and Development and Teen Volunteer programs. latest advances in digital supporting scientists in percentages significantly industry or other research- Educator Education track, a accepts new students in They competed for slots in Research Week based health, including wearable clinical settings, research exceed the national related areas based on three- to four-year program three rotations every year. on their grade point averages, essays and other biosensors, social media associates in imaging average. Additionally, the their skills and talents, designed to teach chaplains Ten students graduated criteria. This year’s diverse class included 10 girls analytics, smartphone apps research centers, or institute offers more than and receive support and how to train other spiritual in the first rotation of the and nine boys from public and private schools. and clinical informatics. The research or application 100 continuing education guidance from experienced advisers and leaders. program’s return, which For such students, Research Week provides executive-style program scientists. Since 2015, the courses annually while professionals. Cedars-Sinai’s CPE program more than doubled to 22 an invaluable opportunity for exploration in a spans 20 months and Department of Biomedical providing preceptor was fully accredited in 2015, in the second rotation. leading-edge facility — as well as a stepping features evening classes to Sciences program has experiences and clinical and the fellowship admitted stone to a career in medicine and science. attract working clinicians, tripled its master’s degree rotations every year for its first student this year. researchers, executives offerings. students from more than ABOVE: Research associate Jordan Nunnelee instructs and administrators from 20 affiliate nursing schools. area high school students Laura Elizarraras, Wyssanie the fields of healthcare, Chomsin, Robert Sher and Andre Rabizadeh in a lab at the Cedars-Sinai Board of Governors Regenerative insurance, pharmaceuticals Medicine Institute during the 2017 Research Week. and biotech.

30 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 31 THE CAMPAIGN GRATITUDE IN ACTION

:merci • धन्यवाद very day, Cedars-Sinai is charting the future of breakthrough medical THE NUMBERS • متشكرم • Спасибо CEDARS-SINAI • danke • 多謝 • asante • ךל הבר FORהדות • thank you • gracias a dank • 谢谢 • tack • ndiyabulela enkosi • ευχαριστω • mersi • ありがとうございました • tesekkür discovery and clinical care. Its progress at the forefront of leading-edge Спасибо • danke • 多謝 asante research and treatment is a product of inspired collaboration among its $600 • ךל הבר הדות • ederim • ขอบคุณ • salamat • thank you • gracias • • merci • धन्यवाद • a dank • 谢谢 • tack • ndiyabulela enkosi • ευχαριστω • mersi E many stakeholders: physicians, surgeons, scientists, patients and the many dedicated متشكرم million ךל הבר הדות • ありがとうございました • tesekkür • ederim • ขอบคุณ • salamat • thank you • gracias Спасибо • danke • • asante • • merci • • a dank • 谢谢 • tack • ndiyabulela investors whose commitment makes this work possible. CAMPAIGN GOAL BY धन्यवाद 2018, THE BIGGEST متشكرم 多謝 enkosi • ευχαριστω • ありがとうございました • tesekkür • ederim • ขอบคุณ • salamat • thank you In 2011, Cedars-Sinai launched an ambitious seven-year, $600 million fundraising FUNDRAISING EFFORT merci • धन्यवाद IN CEDARS-SINAI'S • متشكرم • Спасибо • danke • 多謝 • asante • ךל הבר הדות • mersi • gracias a dank • 谢谢 • tack • ndiyabulela enkosi • ευχαριστω • mersi • ありがとうございました • tesekkür campaign to expand that work, blazing a trail to extraordinary advances capable HISTORY Спасибо • danke • 多謝 of transforming outcomes and improving lives. The Campaign for • ךל הבר הדות • ederim • ขอบคุณ • salamat • thank you • gracias merci • धन्यवाद • a dank • 谢谢 • tack • ndiyabulela enkosi • ευχαριστω • متشكرم • asante mersi • • tesekkür • ederim • • salamat • thank you • gracias Cedars-Sinai centers on five distinct themes: disease 6,166 ありがとうございました ขอบคุณ NEW DONORS merci • धन्यवाद • a dank • 谢谢 • tack prevention and control, precision health and targeted • متشكرم • Спасибо • danke • 多謝 • asante • ךל הבר הדות ndiyabulela enkosi • ευχαριστω • mersi • ありがとうございました • tesekkür • ederim • ขอบคุณ therapies, aging and longevity, innovations in healthcare salamat • thank you • gracias • • • danke • • asante • thank and technology, and education and training. Across these areas 8,843 متشكرم Спасибо 多謝 ךל הבר הדות merci • धन्यवाद a GRATEFUL PATIENT • متشكرم • Спасибо • danke • 多謝 • asante • ךל הבר הדות • you • gracias dank • 谢谢 • tack • ndiyabulela enkosi • ευχαριστω • mersi • ありがとうございました • tesekkür and beyond, Cedars-Sinai has played a global leadership role in reshaping the DONORS Спасибо • danke • 多謝 asante healthcare landscape — raising the bar on high-impact research and quality care • ךל הבר הדות • ederim • ขอบคุณ • salamat • thank you • gracias .merci • धन्यवाद • a dank • 谢谢 • tack • ndiyabulela enkosi • ευχαριστω • mersi with tangible benefits for individuals in this community and around the world • متشكرم • ךל הבר הדות • ありがとうございました • tesekkür • ederim • ขอบคุณ • salamat • thank you • gracias merci • धन्यवाद • a dank • 谢谢 • tack • ndiyabulela To date, the campaign has raised more than $550 million. Generous donors, members • متشكرم • Спасибо • danke • 多謝 • asante enkosi • ευχαριστω • ありがとうございました • tesekkür • ederim • ขอบคุณ • salamat • thank you of the extended Cedars-Sinai family, have given their time and resources to help merci • धन्यवाद • متشكرم • Спасибо • danke • 多謝 • asante • ךל הבר הדות • mersi • gracias a dank • 谢谢 • tack • ndiyabulela enkosi • ευχαριστω • mersi • ありがとうございました • tesekkür realize a powerful vision: next-generation healthcare that makes a difference for, .Спасибо • danke • 多謝 and is accessible to, everyone • ךל הבר הדות • ederim • ขอบคุณ • salamat • thank you • gracias merci • धन्यवाद • a dank • 谢谢 • tack • ndiyabulela enkosi • ευχαριστω • متشكرم • asante mersi • ありがとうございました • tesekkür • ederim • ขอบคุณ • salamat • thank you • gracias merci • धन्यवाद • a dank • 谢谢 • tack • متشكرم • Спасибо • danke • 多謝 • asante • ךל הבר הדות ndiyabulela enkosi • ευχαριστω • mersi • ありがとうございました • tesekkür • ederim • ขอบคุณ متشكرم • Спасибо • danke • 多謝 • asante • ךל הבר הדות • salamat • thank you • gracias merci • धन्यवाद • متشكرم • Спасибо • danke • 多謝 • asante • ךל הבר הדות • thank you • gracias a dank • 谢谢 • tack • ndiyabulela enkosi • ευχαριστω • mersi • ありがとうございました • tesekkür Спасибо • danke • 多謝 asante • ךל הבר הדות • ederim • ขอบคุณ • salamat • thank you • gracias merci • धन्यवाद • a dank • 谢谢 • tack • ndiyabulela enkosi • ευχαριστω • mersi • متشكرم • ךל הבר הדות • ありがとうございました • tesekkür • ederim • ขอบคุณ • salamat • thank you • gracias merci • धन्यवाद • a dank • 谢谢 • tack • ndiyabulela • متشكرم • Спасибо • danke • 多謝 • asante enkosi • • ありがとうございました • tesekkür • ederim • • salamat • thank you ευχαριστω ขอบคุณ CEDARS-SINAI REPORT TO THE COMMUNITY 2018 33 merci • धन्यवाद • متشكرم • Спасибо • danke • 多謝 • asante • ךל הבר הדות • mersi • gracias a dank • 谢谢 • tack • ndiyabulela enkosi • ευχαριστω • mersi • ありがとうございました • tesekkür Спасибо • danke • 多謝 • ךל הבר הדות • ederim • ขอบคุณ • salamat • thank you • gracias THE CAMPAIGN FOR CEDARS-SINAI

DISEASE PREVENTION PRECISION HEALTH AND AND CONTROL TARGETED THERAPIES Giving back: Every gift counts: Ari Engelberg Ilene and Jeff Nathan 74 percent of donors 82 percent of donors Cedars-Sinai Board of Directors member Ari Engelberg Longtime supporters Ilene and Jeff Nathan recently bolstered are grateful patients. gave less than $250. has a connection to the health system spanning three the Liver Transplant/Organ Procurement Research Fund generations — his grandfather, father and uncle all built with a gift reflecting their respect for Cedars-Sinai’s their medical careers here — but his support for research pioneering work in advancing treatments for liver disease, into inflammatory bowel disease (IBD) is about the future. as well as for the leadership of Andrew S. Klein, MD, MBA, Engelberg and his wife, Jennifer Barry, DDS, have seen director of the Cedars-Sinai Comprehensive Transplant the impact of IBD firsthand through their son’s battle with Center, and the Esther and Mark Schulman Chair in Surgery

Crohn’s syndrome, and they want to help other patients by and Transplantation Medicine. “Andy Klein has built a superb accelerating development of more effective treatments. Their transplant team. They do great work,” says Jeff, who also gift supports the innovative work of Stephan R. Targan, MD, serves on the Cedars-Sinai Board of Directors. “We like to <$250 >$250 director of the F. Widjaja Foundation Inflammatory Bowel support Cedars-Sinai’s areas of great expertise to keep them

and Immunobiology Research Institute, director of the sustainable because we want Cedars-Sinai to maintain its Inflammatory Bowel Disease Center, and the Feintech Family strong leadership position.” Chair in Inflammatory Bowel Disease. “Ari’s enthusiasm has inspired me to redouble efforts to move science even more Louis B. Mayer Foundation rapidly to improve patient care,” Targan says. Advancing medical research has long been a priority of the Louis B. Mayer Foundation, including innovative studies in Tori Shuken women’s heart disease. The foundation awarded its first Revenue by source: Vista Automotive Family President Tori Shuken met grant in this arena to a study led by Chrisandra Shufelt, MD, (July 1, 2016 – June 30, 2017) renowned neurosurgeon and scientist Keith Black, MD, MS, associate director of the Barbra Streisand Women’s after her father, Steve, developed advanced cancer about Heart Center at the Cedars-Sinai Heart Institute, and Total raised in FY2017: $76,823,129 12 years ago. Her father has since passed away, but Black — director of its Women’s Hormone and Menopause Program. Total number of donors: 12,210 professor and chair of the Department of Neurosurgery, The study explores the relationship between estrogen director of the Maxine Dunitz Neurosurgical Institute, deficiency in young women and preclinical cardiovascular director of the Johnnie L. Cochran Jr. Brain Tumor Center disease. Judi Farkas, a member of the Louis B. Mayer ■ INDIVIDUALS: 76% at Cedars-Sinai, and the Ruth and Lawrence Harvey Chair Foundation Board of Trustees, says Shufelt’s pursuit of a in Neuroscience — performed the brain surgery that gave new path toward earlier intervention in heart disease “fits him more time. The Shukens then learned about Black’s the foundation’s desire to support research that can do the pioneering research, which includes the development of a most good for the most people.” ■ FOUNDATIONS: 17% brain cancer vaccine and techniques to deliver anticancer drugs to tumors more precisely. They have honored Steve’s memory by supporting Black’s research ever since. “Dad ■ CORPORATIONS: 5% would be very pleased,” Tori says.

■ ESTATES AND TRUSTS: 2%

34 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 35 THE CAMPAIGN FOR CEDARS-SINAI

AGING AND LONGEVITY INNOVATIONS IN HEALTHCARE EDUCATION AND TRAINING AND TECHNOLOGY MILESTONE GIFTS Bruce and Linda Steinbaum B. N. Maltz Foundation TO CEDARS‑SINAI Bruce and Linda Steinbaum know that even small gifts can The late Ben N. Maltz was a longtime Cedars-Sinai supporter Ron and Andrea Hein (July 1, 2016 – June 30, 2017) add up to big differences in battling conditions such as One year after being aided by Cedars-Sinai orthopedist who instilled in his children, Elaine Goldsmith and Chuck Parkinson’s disease. In building the Steinbaum Parkinson’s Sang Do Kim, MD, to fully recover from a serious fall, Ron Maltz, a sense of commitment to the community and the Research Fund, they seek contributions of any size to Hein learned he needed surgery to remove cancerous cells medical center. Along with Elaine’s son, Russell Goldsmith — Erika J. Glazer foster crucial translational discoveries. The Steinbaums’ in his esophagus. The care that the retired finance executive a member of the Cedars-Sinai Board of Directors — they commitment to fundraising grew out of their heartbreaking received — and the support provided by Cedars-Sinai to his have continued his legacy by funding the Ben Maltz Chair Don S. Levin Trust/Thomas D. Gordon experience with Bruce’s late father, Jerry, as the progressive wife, Andrea — inspired the couple to establish the Andrea in Cancer Therapeutics at Cedars-Sinai through the B. N. movement disorder overtook his body. They are encouraged and Ron Hein Thoracic Surgery Initiative in the Department Maltz Foundation. The endowment supports cancer research B. N. Maltz Foundation by the potential advances arising from Cedars-Sinai of Surgery. “Thanks to the people here, it’s almost like the and education. Michael Freeman, PhD — director of the research in identifying underlying causes of Parkinson’s and accident and the surgery didn’t happen,” Ron says. Clark B. Division of Cancer Biology and Therapeutics Research in Cookie and Ron Markowitz new targets for treatment. “Cedars-Sinai is a remarkable Fuller, MD, associate director of Thoracic Surgery, performed the Department of Biomedical Sciences, director of Basic institution, and researchers are doing extraordinary work the complex procedure. (Traditionally done through multiple Science Research in the Department of Surgery and vice Nancy Ann Mellen Foundation that could lead to better outcomes for Parkinson’s patients,” large incisions, it was instead completed through small chair of Surgical Research in the Department of Surgery — Ted* and Hedy Orden and Family Bruce says. “It’s gratifying to do something to help. incisions and fiber-optic guidance.) “This is an extremely has been named the inaugural Ben Maltz Chair in Cancer Hopefully, thousands of people like me are doing the same.” generous and appreciated gift,” Fuller says. “And if it can Therapeutics. A professor in the departments of Surgery Dolly Parton raise the level of performance of physicians and improve and Biomedical Sciences, he helps train the next generation Nick Gross and Natasha Barritt outcomes, then it’s money well spent.” of clinical scientists while studying molecular processes that Nelson and Claudia Peltz Family Foundation The diabetes epidemic has had a personal impact on Nick cause cancer cells to spread throughout the body. Gross, director of The William and Sue Gross Foundation, Russell Grossman Margie & Robert E. Petersen Foundation and his fiancée, Natasha Barritt. They offer daily support Russell Grossman was so impressed by the care his Betty Weider as Natasha’s mother copes with the challenges of living father received at Cedars-Sinai that he joined the Board When Betty Weider visits her cardiologist, Bojan Cercek, MD, Women’s Guild with diabetes, and her struggles have inspired them to of Governors in 2007. He soon met Clive Svendsen, PhD, PhD, at Cedars-Sinai, she sometimes feels as though she’s help others as well. Following the lead of Nick’s parents, director of the Board of Governors Regenerative Medicine “his only patient,” she says, “because of his caring attitude *Deceased William and Sue Gross, they give to support Cedars-Sinai’s Institute (RMI), and the Kerry and Simone Vickar Family and attention to detail.” Her late husband, Joe Weider — innovative diabetes research and treatment. They are Foundation Distinguished Chair in Regenerative Medicine. publisher of worldwide health and fitness magazines and particularly excited by the work of Ruchi Mathur, MD, and Svendsen shared some of the novel approaches RMI is father of the modern-day fitness revolution — felt the Mark O. Goodarzi, MD, PhD, in the Cedars-Sinai Division developing to tackle amyotrophic lateral sclerosis (ALS) and same. Joe passed away in 2013 at the age of 93. “Dr. Cercek of Endocrinology, Diabetes and Metabolism. “We felt so Parkinson’s disease as well as to advance treatments for prolonged my husband’s life and, most importantly, the reassured after hearing about research that could lead to other devastating conditions through personalized medicine quality of his life, by many years,” Betty says. Her gratitude new ways to prevent and treat diabetes,” Natasha says. that uses a patient’s own stem cells for therapy and drug to Cercek — director of the Coronary Care Unit, co-director testing. Grossman, senior managing director at Bernstein of the Atherosclerosis Research Center, and the Eleanore Global Wealth Management, became a strong and steady and Harold Foonberg Chair in Cardiac Intensive Care — supporter of RMI’s research. “Cedars-Sinai is one of the led her to honor Joe’s memory with a gift that supports leading institutions in the world in this arena,” he says. cardiology clinical research fellowships and establishes the Betty and Joe Weider Cardiac Intensive Care Unit at Cedars- Sinai. Betty wants others to benefit from the education and Visit us online at giving.cedars-sinai.edu research of Cercek and his team for the potential it has to to learn how you can partner with “help many people live longer, healthier, more active lives.” Cedars‑Sinai to improve patients’ lives.

36 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 37 THE NUMBERS JULY 1, 2016 – JUNE 30, 2017

FINANCIAL SNAPSHOT

886 1,665 INCOME AND EXPENSES LICENSED BEDS RESEARCH PROJECTS Revenue from patient care and other sources $ 3,300,312,000 Expenses $ 2,979,597,000 Operating income $ 320,715,000 260,550 14,523 Loss on extinguishment of debt $ (42,143,000) PATIENT DAYS FULL-TIME EMPLOYEES Investment income $ 173,014,000 (approximately 698 per day) Net income to reinvest in Cedars-Sinai’s mission $ 451,586,000

USES OF NET INCOME Long-term debt to be repaid $ 1,305,430,000 765,458 2,166 OUTPATIENT VISITS PHYSICIANS ON Capital expenditures for facilities, renovation, technology and other $ 504,907,000 (approximately 2,060 per day) MEDICAL STAFF This year’s payment on long-term debt $ 22,390,000

COMMUNITY BENEFIT CONTRIBUTION Unreimbursed cost of direct medical care for the poor and underserved $ 111,981,000 50,446 424 (excludes the unreimbursed cost of caring for Medicare patients) ADMISSIONS RESIDENT AND FELLOW Charity care and uncompensated care for the uninsured $35,999,000 POSITIONS Unreimbursed cost of caring for Medi-Cal patients $75,982,000 Unreimbursed cost of direct medical care for Medicare patients $ 378,679,000 Unreimbursed cost of specialty government programs $ 1,148,000 92,109 2,650 Community benefit programs, charitable contributions, EMERGENCY VISITS VOLUNTEERS and education and training for physicians and other health professionals$ 108,634,000 165,260 (includes hundreds of free community education and medical screening/immunization programs VOLUNTEER HOURS offered at the medical center and in local schools, homeless shelters and community centers) Research programs $ 197,500,000 256,075 $797,942,000 Total cost of research $197,500,00 PATIENTS CARED FOR CONTRIBUTION FOR Less: Research funding from grants ($125,432,000) BY CEDARS‑SINAI COMMUNITY BENEFIT Net costs of research $72,068,000 MEDICAL NETWORK Total quantifiable community benefit $ 797,942,000

38 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 39 WHERE WE ARE PATIENT CARE

H Cedars-Sinai Medical Center Primary Care, Cardiology, PLAYA VISTA Key 8700 Beverly Blvd. Gastroenterology, General Surgery, Primary Care, Pediatrics, Hand Surgery, Infectious Diseases, Obstetrics and Gynecology H Hospital H Marina Del Rey Hospital Sports Medicine, Nephrology, Neurology, 12746 W. Jefferson Blvd. 4650 Lincoln Blvd. Obstetrics and Gynecology, Urgent Care Otolaryngology, Plastic and Reconstructive RIVERSIDE Primary Care H California Rehabilitation Institute Surgery, Urology Cardiology 2070 Century Park East 8635 W. Third St., West Tower 3400 Brockton Ave. Specialty Care Urgent Care Locations SAN BERNARDINO Lancaster Ambulatory Surgery Center Primary Care, Geriatrics, Cardiology, 8501 Wilshire Blvd., Beverly Hills Endocrinology, Mental Health/Behavioral Cardiology Palmdale Imaging 10100 Culver Blvd., Culver City Health, Ophthalmology, Optometry, 399 E. Highland Ave., Suite 2 12746 W. Jefferson Blvd., Playa Vista Pediatric Reconstructive Surgery, West Hills Plastic and Reconstructive Surgery, SANTA MONICA Van Nuys 210 Ambulatory Surgery North Hollywood ANAHEIM Pulmonology, Rheumatology Orthopedics, Sports Medicine 250 N. Robertson Blvd. 2121 Wilshire Blvd., Suite 201 101 2400 E. Katella Ave. Primary Care, Oncology, Endoscopy Encino BEVERLY HILLS Orthopedics, Podiatry 12400 Wilshire Blvd., Suite 100 Tarzana Ambulatory Surgery 200 N. Robertson Blvd. Pasadena 450 N. Roxbury Drive, Suites 240 and 600 Gastroenterology Primary Care, Pediatrics, Endocrinology, 1919 Santa Monica Blvd. 5 101 Cardiology, Executive Health, General Pain Management Surgery, Integrative Health, Obstetrics 8501 Wilshire Blvd. Oncology and Gynecology, Pulmonology 2001 Santa Monica Blvd., Suite 560W Pulmonology 405 8631 W. Third St., East Tower 110 127 S. San Vicente Blvd. Orthopedics, Sports Medicine Cardiology, Gastroenterology, 2020 Santa Monica Blvd., Suite 400 Pulmonology CULVER CITY Cedars-Sinai TARZANA Medical Center 8536 Wilshire Blvd. Primary Care, Gastroenterology, Imaging Beverly Hills 10 10100 Culver Blvd. Oncology, Surgical Oncology Downtown Dermatology, Endocrinology, Urology (Breast and Thyroid Cancer) 18133 Ventura Blvd., Suite 200 West L.A. L.A. Riverside 99 N. La Cienega Blvd. DOWNTOWN L.A. California Rehabilitation Cardiology Primary Care, Nephrology Institute San Bernardino Endoscopy 1245 Wilshire Blvd., Suite 703 5525 Etiwanda Ave., Suite 320 Santa Monica 10 8536 Wilshire Blvd., Suite 102 Upland Orthopedics, Sports Medicine Culver City Imaging 1700 E. Cesar E. Chavez Ave. UPLAND 8700 Beverly Blvd., Suite 8516S Cardiology EL SEGUNDO 625 N. 13th Ave. Marina Del Rey 8705 Gracie Allen Drive 8631 W. Third St., Suite 120 East Cardiology Hospital 390 N. Sepulveda Blvd. VAN NUYS 110 127 S. San Vicente Blvd., Suite A-2500 Primary Care, Nephrology Westchester 310 N. San Vicente Blvd., Second Floor ENCINO 15211 Vanowen St., Suite 315 605 250 N. Robertson Blvd. Oncology 200 N. Robertson Blvd. 16133 Ventura Blvd., Suite 470 WEST HILLS Playa Vista Oncology 710 444 S. San Vicente Blvd. LANCASTER 23101 Sherman Place, Suite 410 8501 Wilshire Blvd. Cardiology 99 La Cienega Blvd. 43723 29th St. West WESTCHESTER 9090 Wilshire Blvd. Suite 200 Ambulatory Surgery El Segundo Anaheim MARINA DEL REY 6801 Park Terrace Drive, Suite 300 Oncology Primary Care 405 9090 Wilshire Blvd. 4644 Lincoln Blvd., Suite 111 Primary Care, Orthopedics, Sports Medicine Orthopedics, Sports Medicine NORTH HOLLYWOOD 6801 Park Terrace Drive 8737 Beverly Blvd. Primary Care, Nephrology 12660 Riverside Drive, Suite 225 WEST L.A. Physical Therapy & Rehabilitation Oncology 2070 Century Park East PALMDALE 11818 Wilshire Blvd. Cardiology Primary Care 41210 11th St. West Primary Care 8767 Wilshire Blvd. 11645 Wilshire Blvd. PASADENA Orthopedics, Sports Medicine 301 N. Lake Ave.

40 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 41 Lancaster Palmdale WHERE WE ARE COMMUNITY WHERE WE ARE EDUCATION

210 210 Reseda

101 101

La Cañada Flintridge 5 5 101 101 Hollywood Hollywood 405 110 405 110 Upland Cedars-Sinai Cedars-Sinai Medical Center Medical Center Beverly Hills 10 10 Downtown Central L.A. L.A. Downtown San Bernardino L.A.

Santa Monica 10 10 Culver City Venice

605 605 Huntington Riverside South L.A. Park 110 Westchester South Gate Inglewood 110 Inglewood

Hawthorne Watts

405 405 Compton 710 710

Carson

Community Clinic Initiative Cedars-Sinai Share and Care Note: Site locations shown Cedars-Sinai Medical Center Eisner Pediatric & Family Saban Community Clinic (50+ partners and grantees) (28 sites) above are approximate. Medical Center (2 locations) Cedars-Sinai Kerlan-Jobe Key Key Cedars-Sinai COACH Cedars-Sinai Community Institute The KHEIR Center Hospital Venice Family Clinic Hospital for Kids® (51 sites) Health and Education Children’s Dental Center Los Angeles Christian Urgent Care Urgent Care (17 sites) Cedars-Sinai Healthy Habits of Greater Los Angeles Health Centers Primary Care Primary Care (30 sites) Cedars-Sinai Youth Specialty Care Specialty Care Planned Parenthood Employment and Los Angeles Ambulatory Surgery Center Ambulatory Surgery Center Development (1 site)

42 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 CEDARS-SINAI REPORT TO THE COMMUNITY 2018 43 LEADERSHIP 2017 OUR MISSION

Thomas M. Priselac Marc H. Rapaport Steven Romick Leslie Vermut President and CEO Chair, Board of Directors Vice Chair, Board of Directors Secretary, Board of Directors

BOARD OF DIRECTORS LIFE TRUSTEES EXECUTIVE MANAGEMENT Cedars‑Sinai Health System, a nonprofit, independent healthcare organization, is Mohamed (Mike) Ahmar Bernard Briskin Peter E. Braveman, Esq. committed to: Michael Alexander, MD Steven D. Broidy* Senior Vice President, Legal Affairs Robert K. Barth Judy Carroll Linda Burnes Bolton, DrPH, RN, FAAN • Leadership and excellence in delivering John Bendheim Maxine N. Dunitz Senior Vice President, Nursing, and Chief Nursing Executive quality healthcare services Laura W. Brill Robert M. Eller Bryan Croft Senior Vice President, Operations Ilana Cass, MD Aaron R. Eshman • Expanding the horizons of medical Dale Cochran Lawrence N. Field** Darren Dworkin knowledge through biomedical research Senior Vice President, Enterprise Information Systems, John Coleman Chester Firestein and Chief Information Officer Robert C. Davidson Michael R. Forman • Educating and training physicians and Mark Gavens Ari Engelberg Marilyn Gilfenbain Executive Vice President, Hospital Operations, other healthcare professionals Deborah Freund, PhD Philip E. Hixon and Chief Operating Officer, Cedars-Sinai Medical Center Russell Goldsmith Sue Neuman Hochberg Richard B. Jacobs • Striving to improve the health status of Mark S. Greenfield Irwin Hoffman, MD Executive Vice President and Chief Strategy Officer our community Vera Guerin* Sally Kurtzman John Jenrette, MD Andy Heyward Marion Laurie Executive Vice President, Cedars-Sinai Medical Network Quality patient care is our priority. Eric Holoman John C. Law* Michael L. Langberg, MD Providing excellent clinical and service David B. Kaplan Don S. Levin** Senior Vice President, Medical Affairs, and Chief Medical Officer quality, offering compassionate care, Scott Karlan, MD John W. Mack Jill Martin and supporting research and medical Jeffrey Katzenberg Edward Meltzer Senior Vice President and Chief Operating Officer education are essential to our mission. Steven Koh Walter Mirisch Cedars-Sinai Medical Network Stewart Kwoh Todd M. Morgan Shlomo Melmed, MD This mission is founded in the ethical and Executive Vice President, Academic Affairs, Thomas J. Leanse Steven Nichols and Dean of the Faculty cultural precepts of the Judaic tradition, Jose de Jesus Legaspi Luis Nogales which inspires devotion to the art and Arthur J. Ochoa, JD James M. Lippman Lynda Oschin Senior Vice President, Community Relations and Development, science of healing, and to the care we Joshua Lobel Bruce W. Rabin and Chief Development Officer give our patients and staff. Philomena McAndrew, MD David I. Saperstein Andrew Ortiz Peggy Miles, MD*** Milton Slotkin**** Senior Vice President, Human Resources and James A. Nathan Barbra Streisand Organization Development Christopher Ng, MD Sanford B. Weiss Edward M. Prunchunas Lawrence B. Platt* Walter Zifkin Executive Vice President, Finance, and Chief Financial Officer Antony P. Ressler Scott Weingarten, MD Richard Riggs, MD Senior Vice President and Chief Clinical Transformation Officer Mark S. Siegel* David M. Wrigley Steven Spielberg Senior Vice President, Finance Leslie Spivak Clement Yang, MD

* Past Chair of the Board ** Honorary Life Trustee *** Chief of Staff **** Deceased

44 CEDARS-SINAI REPORT TO THE COMMUNITY 2018

8700 Beverly Boulevard Los Angeles, California 90048

1-800-CEDARS-1 (1-800-233-2771) cedars‑sinai.org

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