VOLUME 3 ISSUE MONTHLY MEDICAL STAFF 06 NEWSLETTER ProgressNotes J U N E 2011 TORRANCE MEMORIAL MEDICAL CENTER

this issue Relay for Life P.1 Lung Screening Program P.2 Clinical Alert P.2 Medical Staff Calendar P.3 Roster Updates P.4 MEC Approvals P.5

Clinical Alert: Angioplasty Combined with Stenting Plus Aggressive Medical vs. Aggressive Medical Therapy Alone for Intracranial Arterial Stenosis

The National Institute of Neurological Disorders and Stroke (NINDS) has stopped enrollment in a clinical trial that is evaluating whether intracranial angioplasty combined with stenting adds benefit to aggressive medical therapy alone for preventing stroke in patients with symptomatic intracranial arterial stenosis. The study was the first prospective randomized multicenter trial to compare aggressive medical management alone versus aggressive medical management plus angioplasty combined with stenting in patients with symptomatic highgrade stenosis of a major intracranial artery. Recruitment began in November of 2008 and was halted on April 5, 2011 after 451 (59%) of the planned 764 patients had been enrolled at 50 participating sites in the US. At the time of the most recent DSMB review, 14% of patients treated with angioplasty combined with stenting experienced a stroke or died within the first 30 days after enrollment compared with 5.8% of patients treated with medical therapy alone, a highly significant difference. The SAMMPRIS Executive Committee is in agreement with NINDS and the DSMB that enrollment in the study should be stopped and that the trial data currently available indicate that aggressive medical management alone is superior to angioplasty combined with stenting in patients with recent symptoms and high grade intracranial arterial stenosis. All are indebted to the patients who contributed to this important study. Read the entire clinical alert at http://www.nlm.nih.gov/databases/alerts/intracranial_arterial_stenosis.html

For printed copies of the alert please contact Anita Klecker, Health Sciences Librarian/CME Coordinator, at [email protected] or call 310-517-4720.

Lung Screening Program

Study reveals screening benefits Recently the National Cancer Institute released initial findings of its National Lung Screening Trial, a national research study that enrolled over 50,000 current and ex-smokers with a high risk of developing lung cancer. Analysis of the data gathered in this trial showed that significantly fewer study participants died of lung cancer if they under went low-dose spiral CT (Computed Tomography) screening compared to participants who had a standard chest x-ray. The study suggests that CT lung screening leads to early detection and better survival for those at risk for the development of smoking-related lung cancer. Who should consider CT scan lung screening? Members of the Lung Program Team. If you are between the ages of 50 and 74 years and have a more than incidental smoking history, you should consider being screened. What does CT scan for lung cancer screening cost? For more information about the lung cancer screening The cost of the exam is $350. It is not covered by insurance so and treatment, call the Lung Program Nurse Navigator payment is due at the time of exam. referral is re- at (310) 517-4665, or visit quired. www.TorranceMemorial.org/lungscreening How do I make an appointment? Call Torrance Memorial Centralized Scheduling at (310) 517- 4738.

Cardiovascular disease remains the leading cause of death worldwide. Recognizing patients at risk is the key to early intervention and decreased morbidity and mortality. Join us to hear many nationally renown leaders in cardiovascular and metabolic diseases provide information about new treatment guidelines and advancements-including heart failure, diabetes, vascular disease and sudden cardiac death.

Qualifies for CME Credit

Friday, July 15, 2011 Registration 7:30 am Conference 8:15 am - 4 pm

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Medical Staff Calendar June Monday Tuesday Wednesday Thursday Friday 1 2 3

7:00a CV Review Conference.WT-D 12:30p Critical Care…………….WT-C 12:30p MSPI…………………….WT-D

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7:00a Heart Failure Program...WT-D 7:30a …….….WT-B 7:00a Anesthesia PI………..WT-Aud 7:00a Breast Tumor Board…...WT-D 7:00a Surgery Dept……….WT-Aud 4:00p Bariatric Surgery……….WT-C 12:30p Infection Control/P&T….WT-D 7:00a CV Review Conference.WT-D 7:30a Tumor Board……………WT-D 7:30a IRB……………………..WT-D 8:00a ………….WT-A 12:30p PI……………..WT-B 12:30p CME Conference…..HCC 1&2

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7:30a Physician Alignment…..WT-B 12:30p Medical Ed. Library…...HCC-4 7:00a CV Review Conference.WT-D 7:00a Breast Tumor Board..WT-Aud 12:00p Donor & Transfusion...WT-D 12:30p ……………..HCC-4 12:30p …………WT-C 12:30p CME Conference…..HCC 1&2 7:00a Endovascular PI………..WT-C 12:30p Credentials……………..WT-C 5:00p Professional Relations...WT-C 7:30a Tumor Board………...WT-Aud 6:00p MEC……………………..WT-D 9:00a Emergency Dept……...HCC-1 12:30p Pediatric Dept……….WT-Aud

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12:00p Burn & Wound………….WT-C 7:00a Practitioner Well Being..WT-C 7:00a CV Review Conference.WT-D 7:00a Breast Tumor Board..WT-Aud 12:00p Dept………..HCC-1 12:30p Bioethics………………..WT-B 7:30a Tumor Board………...WT-Aud 12:30p CME Conference…..HCC 1&2 12:30p Credentials……………..WT-C

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7:30a Vascular Medicine…..…WT-B 12:30p OB/GYN Dept……….WT-Aud 7:00a CV Review Conference.WT-C 4:00p Bariatric Surgery……….WT-C

June 1, 2011 June 22, 2011 CME CONFERENCES NO CONFERENCE “Hypertension Update” Thomas Heywood, M.D. Wednesdays, 12:30 pm June 8, 2011 Loma Linda University School of Health Conference Center “Bariatric Surgery” Medicine Commercial Support: Daiichi Sankyo Kevin Reavis, M.D. Torrance Memorial Medical Center is accredited by the Institute for U.C. Irvine School of Medicine Medical Quality/California Medical Association (IMQ/CME) to provide Commercial Support: None June 29, 2011 continuing for . Torrance Memorial NO CONFERENCE Medical Center takes responsibility for the content, quality, and scientific integrity of this CME activity. Torrance Memorial Medical June 15, 2011 Center designates this live activity for a maximum of 1 AMA PRA “Osteoporosis Update” July 6, 2011 Category I credit™. Physicians should claim only the credit commen- surate with the extent of their participation in the activity. This credit Peng Fan, M.D. NO CONFERENCE may also be applied to the CME Certification in Continuing Medical UCLA School of Medicine Education. Commercial Support: Amgen For up-to-the minute conference information call (310) 784-8776. 3

Physician Roster Updates

Change of Address/Phone/Fax Sandra Yee, M.D. John Wong, M.D. Chong Kim, M.D. Internal Medicine 3465 Torrance Blvd., Suite S 2160 W. 190th Street Fax: (310) 373-1253 Torrance, CA 90503 Torrance, CA 90504 Phone: (310) 792-3914 Phone: (310) 214-0811 Clark Fuller, M.D. Fax: (310) 792-3621 Fax: (310) 303-5901 Thoracic Surgery Fax: (310) 652-4053 Barry Wertheimer, D.P.M Anita Newman, M.D. Pediatric Otolaryngology Vivian Liu, M.D. 23639 Hawthorne Blvd., Suite 206 8631 West Third Street, Suite Torrance, CA 90505 440E 1200 Rosecrans Ave #202 Phone: (310) 530-0544 Los Angeles, CA 90048 Manhattan Beach, CA 90266 Fax: (310) 541-0168 Phone: (310) 657-7704 Fax: (310) 652-9906 Keith Bayan, M.D. Farhad Hajaliloo, M.D. Pediatrics Pediatric Orthopedic Jason Kim, M.D. 1200 Rosecrans Ave #202 2840 Long Beach blvd., Suite 440 Internal Medicine Manhattan Beach, CA 90266 Long Beach, CA 90806 2160 W. 190th Street Phone: (562) 595-6646 Torrance, CA 90504 Deceased Fax: (562) 490-0434 Phone: (310) 214-0811 Fax: (310) 783-5594 James Tamkin, M.D. Milton Owens, M.D. Endocrinology Farhad Nowzari, M.D. 22525 Maple Avenue, Suite 102 Urology Torrance, CA 90505 4305 Torrance Blvd., Suite 500 Phone: (714) 997-4448 Torrance, CA 90503 Fax: (714) 997-4449 Phone: (310) 921-1100 Fax: (310) 921-9922 Thomas Togioka, M.D. Cardiology Hyun Lee, D.O. 8540 S. Sepulveda Blvd., Suite 118 Internal Medicine Los Angeles, CA 90045 Phone: (310) 540-1712 Phone: (310) 673-3945 Fax: (310) 382-2118 Fax: (310) 673-0273 Mark Ancheta, M.D. Michael Robinson, M.D. Anesthesia Endocrinology Phone: (310) 681-9380 501 E. Hardy St., Suite 425 Inglewood, CA 90301 Nevine Salama, M.D. Phone: (310) 419-4303 Family Practice Fax: (310) 419-4480 Phone: (310) 792-3645

David Blood, M.D. Diane Ferguson, M.D. Radiology Internal Medicine 6789 Quail Hill Parkway, Suite 728 Phone: (310) 792-3647 Irvine, CA 92603 Phone: (888) 225-0628 Elva Dreisbach, M.D. Fax: (949) 861-9086 Internal Medicine The Medical Staff Newsletter Progress Notes is published monthly for the Medical Staff of Torrance Memorial Medical Center. Phone: (310) 257-2598 Reza Babapour, M.D. Thomas G. Simko, M.D. Christopher Verbin, M.D. Chief of Staff

436 N. Bedford Dr., Suite 212 Plastic Surgery Robin S. Camrin, CPMSM, CPCS Beverly Hills, CA 90210 Fax: (310) 539-6500 Vice President, Medical Staff Services and Performance Improvement Phone: (310) 247-0337 Fax: (310) 247-0343

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Medical Executive Committee Approvals

The following items were presented and actions were approved at the May 10, 2011 Medical Executive Committee meeting:

Treasurer’s Report A. April 2011 Treasurer’s Report

Department of & Gynecology A. Division of Nursing Policy/Procedure entitled, “VBAC: Vaginal Birth After Cesarean”

Department of Pediatrics A. Division of Nursing NICU Policy/Procedure entitled, “VAP Bundle for NICU” B. Revised Patient Care Policy/Procedure entitled, “Alaris Smart Infusion System (Adult/Pediatric/NICU)” C. Pediatric Rapid Response Record

Department of Radiology A. Revised Radiology Privilege Card B. Policy/Procedure entitled, “MRI Enterography Exam”

Department of Surgery A. Criteria Regarding Obesity Surgery B. Bariatric Surgery Selection Criteria C. Bariatric Wound Management D. Bariatric E. Suggested Algorithm for Leaks F. Emergency Room Clinical Pathway G. Suggested Algorithm for DVT Management H. Post-Op Bariatric Surgery Diet Progression for Patients I. Management of Warning Signs of Compliance – Bariatric Surgery Clinical Pathway J. Algorithm for Hemorrhage in Postoperative Bariatric Surgery Patients K. Algorithm for Sepsis/Fever in Postoperative Bariatric Surgery Patients

Bioethics Committee A. Document entitled, “Making Appropriate Care Decisions” B. Revised Bioethics Consultation Guidelines

Credentials Committee – Approvals filed in Medical Staff Services – please see Toni Woodard.

Infection Control/P&T Committee A. Labor and Delivery Routine Admission Orders B. Trial of Labor after Cesarean Section (TOLAC) Orders C. Post Vaginal Delivery Orders Per Protocol Orders D. Cesarean Section Admit Orders E. Post Cesarean Section Orders Per Protocol F. Physician’s Sedation Documentation/History & Physical G. Peripheral Intervention Post-Procedure Orders H. Controlled Substances I. Formulary Review: Ofirmev (acetaminophen injection) – Recommend not to add to Formulary

Institutional Review Board – Approvals filed in Medical Staff Services – please see Yumi Lee.

Surgery Advisory Committee A. Revised Block Scheduling Criteria

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Medical Staff Services

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

ProgressNotes Vol. 3 Issue 06 June 2011

MONTHLY

MEDICAL

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Torrance Memorial’s Planned New Main Tower