Natividad : Inspirando vidas saludables

Personalized Oncology – Is it myth or reality?
2017-09-12 12:00 - 13:00 (America/Los_Angeles) | CA
Arina Ganeles, MD, Hematologist, Community Hospital of the Monterey Peninsula
presented by Arina Ganeles, MD, Hematologist, Community Hospital of the Monterey Peninsula

Every patient is different. Every tumor is different. Personalized cancer treatment is a delivery of the right treatment, based on the tumor genomics (somatic mutations) as well as on individual genetics (germ line mutations) of each patient. The research into cancer biology is propelling rapid development of novel treatments targeting the key molecules that allow cancers to grow and spread. This strategy resulted in new targeted therapies for people living with advanced cancers of the lung, breast, and kidney, as well as several hard-to-treat forms of blood cancer. Today, new molecular technologies can quickly pinpoint molecular changes in the tumor or free-floating cancer DNA in the blood. For a growing number of patients, such changes can be matched to either existing targeted treatments or experimental treatments that are being tested in clinical trials.

Desired Outcomes:

Define ” Precision Oncology”
Identify the difference between the effect of chemotherapy and “target” therapy on cancer cells
Identify the role of Whole Genome Sequencing of tumor cell in treatment of cancer
Recognize the difference between “somatic” and “germline” mutation
Describe the future direction of “precision medicine”
Apply new knowledge in conversations with patients and with appropriate referrals

CME Activity Flyer (PDF)

Effective Physician Hand-Offs
2017-09-25 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Lauren Destino, M.D., Assistant Medical Director, Pediatric Hospitalist Program, Associate Medical Director of Acute Care Units, Lucile Packard Children’s Hospital, Clinical Assistant Professor, Stanford University School of Medicine
with Lauren Destino, MD

Patient care hand-offs between physicians occur frequently and are vulnerable to communication failures with potential impacts on patient safety. This grand rounds will discuss the use of I-PASS communication strategies to enhance hand-off communication.

Desired Outcomes:

Describe the role of communication failures in medical errors and preventable adverse events
Articulate the need for high-quality patient handoffs to reduce the likelihood of communication failures
Describe the implementation of I-PASS evidence-based handoff bundle and its impact on medical errors and patient safety
Utilize some of the strategies discussed in practice as appropriate

CME Activity Flyer (PDF)

Physician Leadership Academy: Leading Through Vision
2017-10-10 13:00 - 16:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
By Invitation Only: Leading Through Vision
Equip yourself with the competencies necessary to facilitate change here at NMC.
The program consists of skill-building workshops delivered by Advisory Board faculty across 2017 and 2018—each one designed to provide you with actionable tools to tackle every day challenges. The workshops are highly interactive, data-rich, and tailored around Natividad’s specific organizational objectives.
Physicial Leadership Academy flyer)

Crucial Conversations for Physicians – Strategies for Optimizing Outcomes
2017-10-18 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Clinton Coil, MD, MPH, FACEP, Chief Quality Officer, Associate Medical Director for Quality and Safety, LA County Harbor-UCLA Medical Center, Assistant Clinical Professor of Medicine, Division of Emergency Medicine Stanford University School of Medicine
Speaker for this CME Activity is Clinton Coil, MD, MPH, FACEP
Crucial Conversations for Physicians – Strategies for Optimizing Outcomes
Reviews show that problem handoffs were a contributing factor in 20-24% of malpractice claims in the outpatient and ED settings. A review of surgical errors found that 28% involved handoffs. An AHRQ survey found that 51% of hospital staff agreed that “important patient care information is often lost during shift changes.”
Desired Outcomes:

Describe the role of communication failures in medical errors and preventable adverse events
Articulate the need for high-quality patient handoffs to reduce the likelihood of communication failures
Apply the Joint Commission’s Sentinel Alert 9/12/17 on Inadequate Hand-off Communication to my practice.

Geared to physicians and ancillary clinical staff.
CME Activity Flyer (PDF)

Hospitals and the Homeless Patient
2017-10-20 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Don A. Barr, MD, PhD, Professor of Pediatrics, and of Education (by courtesy), Stanford University School of Medicine
Speaker for this CME Activity is Don A. Barr, MD, PhD
Hospitals and the Homeless Patient
Homelessness is a growing issue in many areas in California. To address the health care needs and the wellbeing of homeless individuals, it is essential for health care providers to understand the potential causes of homelessness. A principal goal of health care for the homeless is to combine acute medical care with follow-up case management services and referral to permanent supportive housing resources.
Desired Outcomes:

To identify and comprehend the different patterns of the causes of homelessness
To be aware of the complex interaction of mental health and associated substance abuse problems with the behavioral and clinical status of patients encountered in the health care context.
To understand to growing role nationally of providing permanent supportive housing on a “Housing First” basis to those exhibiting chronic homelessness. as appropriate.

Geared to Emergency Department Physicians, Trauma Physicians, and all physician services and ancillary clinical staff.
CME Activity Flyer (PDF)

Prevention of Surgical Site Infections
2017-10-23 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Aussama K. Nassar, MD, MSc, FRCSC, FACS, CHSE, Assistant Clinical Professor of Surgery, Department of Surgery, Section of Trauma & Critical Care, Stanford University School of Medicine
Speaker for this CME Activity is Aussama K. Nassar, MD, MSc, FRCSC, FACS, CHSE
Prevention of Surgical Site Infections
Surgical-site infections (SSIs) are known to complicate 2-5% of all surgeries in the United States. The Centers for Disease Control (CDC) has just issued updated evidence-based guidelines for SSI prevention. The guidelines cover 14 core areas and are intended to be incorporated into existing surgical quality improvement programs to maximize patient safety. As the number of US surgical procedures rise, it is important for physicians to adhere to these guidelines to prevent SSIs.
Desired Outcomes:

Discuss basic principles of surgical site infections
Cite newer landmark studies on prevention of surgical site infections
Apply new guidelines for prevention of surgical site preventions into practice
Recognize the importance of the contribution of patient and caregiver education to the outcome of the procedure

Geared to Emergency Department Physicians, Trauma Physicians, OR Physicians, Anesthesiologists, Radiologists, and ancillary clinical staff.
CME Activity Flyer (PDF)

How Far Have We Come? Emerging Therapies for Fibromyalgia and Chronic Fatigue Syndrome.
2017-11-14 12:00 - 13:00 (America/Los_Angeles) | CA
Scott G. Pritzlaff, MDDepartment of Anesthesiology, Perioperative and Pain MedicineInterventional Pain SpecialistStanford University School of Medicine
Speaker for this CME Activity: Scott G. Pritzlaff, MD
Location: S.E.A. Conference Room
Fibromyalgia and chronic fatigue syndrome are often misunderstood conditions responsible for significant disability. It is critical for primary care and pain providers to have a sound understanding of the diagnostic criteria and treatment options for these patients.
Desired Outcomes:

Review the epidemiology of fibromyalgia and other syndromes that may overlap.
Explain the American College of Rheumatology (ACR) diagnostic criteria for fibromyalgia.
Discuss the etiology of chronic fatigue syndrome such as infection, immune dysfunction, endocrine-metabolic dysfunction, depression.
Select appropriate pharmacologic and non-pharmacologic treatments for fibromyalgia pain management and chronic fatigue syndrome.

CME Activity Flyer PDF

Current Status of Advanced Hemodynamic Resuscitation and Management with Extracorporeal Life Support (ECLS)
2017-11-17 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Bialal M. Shafi, MDCardiothoracic SurgeryPalo Alto Medical FoundationMedical Group
Speaker for this CME Activity: Bialal M. Shafi, MD
Location: Natividad Conference Room
This presentation will explore the applications for adult ECLS including reversible respiratory failure, cardiogenic shock, and ECPR. The discussion will include the importance of early recognition and implementation, and insight into the technical aspect on the use of extracorporeal life support along with risks, benefits and outcomes.
Desired Outcomes:

Identify medical strategies that can potentially benefit patients who are in pulmonary and/or cardiac extremus.
Recognize the selection criteria for determining candidacy for ECLS support.
Define the two types of ECLS: Veno-venous and Veno-arterial and their respective differences.
Describe best practices for basic medical management of the ECLS-supported patient.

CME Activity Flyer PDF

Physician Wellness: Burnout & Wellness
2017-12-15 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
John D. Mark, M.D.Clinical Professor PediatricsPediatric Pulmonary MedicineMedical Director, COREStanford University School of Medicine
Speaker for this CME Activity: John D. Mark, MD
Burnout = Emotional exhaustion, depersonalization, decreased sense of personal accomplishment…
Well Clinicians = Higher Patient Outcomes
Desired Outcomes:

Engage in the process of problem solving.
Discuss the bigger cause that anchors Natividad’s mission.
Participate in the dissolution of the culture of silence.
Develop coping skills to match the level of one’s daily stressors.

CME Activity Flyer PDF

Stop the Bleed
2018-01-09 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
presented by Andrew S. McCague, DO, FACOS, FACS
Trauma and Critical Care Surgeon, Natividad Medical Center
American College of Surgeons Committee on Trauma determined that there may be a delay between time of injury and time first responder is on the scene. Without intervention by civilians, preventable deaths will occur. Medical professionals need to know what civilians might do in instances of mass trauma; they must be exposed to this program to ensure appropriate care is delivered in the case where civilians have already initiated treatment.
Desired Outcomes:

Save lives by utilizing tools to control life-threatening hemorrhage, whether it is caused by unintentional injury, crash, violence or natural disaster;
Discuss the rationale for early use of a tourniquet for life-threatening extremity bleeding.
Demonstrate the appropriate application of a tourniquet to the arm and leg.
Demonstrate the correct application of a topical hemostatic dressing (combat gauze).
Recognize when a patient has been treated using the “Stop the Bleed” protocols and initiate further treatment appropriately.

CME Activity Flyer (PDF)

Making All Physicians Better Teachers by making sense of Competency Based Education
2018-01-19 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
A Family Medicine Faculty Development CME
Roger D. Garvin, MDAssociate Professor MedicineDivision of Family Medicine, Oregon Health and Science University
presented by Roger D. Garvin, MD
We will discuss how medical education has evolved in the last 20 years. The benefits of competency based graduate medical education to faculty and residents will be reviewed.
Desired Outcomes:

Discuss how competency-based graduate medical education has changed over time.
Provide improved feedback to residents.
Recognize the ways in which decisions on resident “entrustment” provide in-depth information to the residency.

CME Activity Flyer (PDF)

When Physicians and Patients Disagree: What To Do?
2018-01-22 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Bruce W. Spring, MDClinical Assistant Professor of PsychiatryKeck School of Medicine of USC
presented by Bruce W. Spring, MD
The conflict between physicians and patients is a common practice experience for all physicians, and one that can be very difficult and stressful for the physician and/or patient. This is a frequent occurrence in medical encounters, and how well it is handled determines not only the clinical outcome of the visit but also impacts on the development of the clinician-patient relationship over time. Physicians like to consider themselves as patient allies and advocates, and it is difficult when they get into conflict with their patients. Most physicians have had relatively little training in effective ways to deal with conflict situations, and tend to rely on whatever skills they have picked up over time. Physicians need an expanded set of communication tools to deal with situations of actual or potential conflict and disagreement between clinician and patient.
Desired Outcomes:

Identify the causes of conflict.
Utilize evidence-based tools to defuse conflict situations with patients.
Transform conflict situations into a sense of partnership and collaboration with patients.
Navigate cultural and/or language barriers to improve communication with patients.

CME Activity Fyer (PDF)

Implications of Marijuana Use to Hospital Care
2018-01-24 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Peter Barelka, MDAnesthesiologist, Veterans Administration HospitalClinical Assistant Professor of AnesthesiologyStanford University School of Medicine
presented by Peter Barelka, MD
The legalization of cannabis is advancing across the United States. Since the science of cannabis is generally not part of today’s medical training, here, healthcare professionals may have an opportunity to close an ‘education gap’ on the science behind cannabis and its implications to clinical hospital care.
Desired Outcomes:

Discuss the historical use of cannabis and the current use in pop culture and political movements.
Review the available OTC varieties and Rx.
Outline the biochemistry of Endocannabinoids and their impact on hospital care.
Analyze the evidence of benefits and of detriments.
Incorporate new knowledge into practice, including discussions with patients.

CME Activity Flyer (PDF)

Improving Pediatric Acute Care Through Simulation (ImPACTS)
2018-02-08 08:00 - 15:00 UTC | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Shruti Kant, M.D.Assistant Clinical ProfessorAssociate Fellowship Program DirectorPediatric Emergency Medicine
Speaker for this CME Activity: Shruti Kant, M.D.
By Invitation Only
2 Sessions (8am-11am or 12 noon-3pm)
ImPACTS is a multi-centered, simulation-based education and QI program with an over-arching goal to enhance
preparedness of all hospitals, and provide high-quality
pediatric emergency training to all health care practitioners caring for ill and injured children.
Desired Outcomes:

To assess Pediatric Readiness of the Emergency Department (ED).
To improve provider knowledge and comfort in the care of critically ill pediatric patients.
To develop an action plan for improvement in ED pediatric readiness.

CME Activity Flyer (PDF)

Strategies Designed to Improve Physician Engagement
2018-03-13 12:00 UTC | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Alan H. Rosenstein, MD, MBAPracticing Internist and Consultant in Physician Behavioral Management, San Francisco
Speaker for this CME Activity
Alan H. Rosenstein, MD, MBA
Today’s complex high stress health care environment has put increasing pressures on physicians as they try to negotiate the changes in medical practice. Many physicians are frustrated and dissatisfied with the way things are going with the associated stress and burnout negatively affecting their attitudes and behaviors toward medical care. More than ever we need our physicians to be engaged in active effective health care management. In order to engage physicians we need to listen their concerns, understand their needs, and provide them with the appropriate resource support to help improve their well- being and better adjust to the pressures of today’s health care environment. By enhancing physician satisfaction and engagement we can help them re-gain the joys of medical practice and improve health care relationships that enhance high quality best practice care.
Desired Outcomes:

Gain a better understanding of the incidence, causes, and impact of forces contributing to frustration, dissatisfaction, stress, and burnout in health care practitioners.
Discuss the negative impact of stress and burnout on attitudes and behaviors that can adversely affect well-being, care relationships, satisfaction, patient safety, and quality of care.
Learn how to develop a proactive organizational approach to address physician concerns and implement programs designed to enhance professional behaviors, staff satisfaction, physician engagement, and overall physician well-being.

CME Activity Flyer (PDF)

Assessing Medical Decision-Making Capacity in Patients with Behavioral Illness: How do you know?
2018-03-16 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Marc Tunzi, MD, MA, Associate Program Director, Family Medicine Residency, Chair, Bioethics Committee, Natividad Medical Center/ Clinical Professor, Department of Family and Community Medicine, University of California, San Francisco
Speaker for this CME Activity: Marc Tunzi, MD, MA
Physicians are often faced with the difficulty of assessing medical decision-making capacity in patients with psychiatric illness who are refusing care. Health professionals often assess capacity differently in practice. Provided their patients have some understanding of their illness and have some plans for meeting basic needs, psychiatrists are often inclined to give patients the freedom to refuse care even if they do not exhibit a full understanding of the medical facts of their case and why they are refusing it. Adult medicine physicians, in contrast, are inclined to require patients to state a more complete understanding of the benefits and burdens of evaluation and treatment before allowing them to refuse care when their refusals might result in adverse medical outcomes. This activity will explore the tension between these approaches and highlight the role of hospital ethics consultation in addressing this conflict.
Desired Outcomes:

Articulate the differences between capacity and competence.
Identify the four sub-abilities of medical decision-making capacity.
Select the best practices when assessing capacity: e.g., consistency with past behaviors vs. the ability “to reason with medical information.”
Employ strategies to engage the patient’s family and friends, personal primary care physician, behavioral health staff, psychiatric consultation, and ethics consultation in the assessment process.

CME Activity Flyer (PDF)

Measuring & Improving Well-Being of Physicians
2018-04-18 12:00 - 13:00 UTC | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Christina Maslach, PhD., Professor of the Graduate School Professor of Psychology, UC Berkeley Medical School
Speaker for this CME Activity: Christina Maslach, PhD
Christina Maslach is a Professor of Psychology (Emerita) and a researcher at the Healthy Workplaces Center at the University of California, Berkeley. She received her A.B. from Harvard, and her Ph.D. from Stanford. She is widely recognized as one of the pioneering researchers on job burnout, who has written numerous articles and books, including The Truth About Burnout, and has developed the leading research measure (the Maslach Burnout Inventory). Several of her articles have received awards for their significance and high impact, including her longitudinal research on early burnout predictors, which was honored in 2012 as one of the 50 most outstanding articles published by the top 300 management journals in the world. Recently, she received the 2017 Application of Personality and Social Psychology Award, as well as a lifetime career achievement award for her work on burnout. Christina received national recognition as Professor of the Year by the Carnegie Foundation and The Council for the Advancement and Support of Education. She has been president of the Western Psychological Association, is a fellow of the American Association for the Advancement of Science and of the European Academy of Occupational Health Psychology, and has received the Berkeley Citation and the Distinguished Teaching Award from U.C. Berkeley.
Overview:
This lecture will provide a summary of what the burnout experience entails, and its causes and consequences. Also, the challenges in responding to burnout, and identify both personal and organizational strategies will be presented.
Desired Outcomes:

Identify and define the three components of burnout and how burnout is assessed in research.

Identify the six areas of job-person mismatches… which predict burnout.

CME Activity Flyer (PDF)
