PEDS Grand Rounds: Maternal-Fetal Microbiome
2017-08-11 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
with Martha V. Douglas-Escobar, MD, FAAP
Martha V. Douglas-Escobar, MD, FAAPNatividad Medical Center Neonatal Intensive Care Unit Director

Up to 90% of all disease can be traced in some way back to the gut and health of the microbiome; More than 10,000 different microbe species have been identified living in the human body; There are 10 times as many outside organisms as there are human cells in the human body: The maternal microbiome is recognized as a key determinant of a range of important maternal and child health outcomes, and together with perinatal factors influences the infant microbiome. Dr. Douglas-Escobar will be presenting this activity on the Maternal-Fetal Microbiome.

Desired Outcomes:

Strategies to protect and restore microbial diversity;
Assess medical consequences of an altered microbiome;
Discuss influences of the early establishment of the microbiome: Maternal-Fetal environment and Ex-Utero determinants.

Physician Leadership Academy: Facilitating Effective Teamwork
2017-08-16 13:00 - 16:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
By Invitation Only: Facilitating Effective Teamwork
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.
Physician Leadership Academy Flyer (PDF)
Physician Leadership Academy Flyer – Detail (PDF)

Trauma Grand Rounds: Mass Casualty Triage
2017-08-17 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Millicent E. Wilson, MD, Emergency Medicine, Disaster Training Specialist – County of Los Angeles, EMS Agency
presented by Millicent E. Wilson, MD

Mass Casualty Incidents, or MCI’s, are a disturbing reality of today’s modern world. There are established best practices in this field, but most physicians are unfamiliar with the procedures. All healthcare professionals need to be prepared to implement their responsibilities for disaster triage, in order to do the greatest good for the greatest number of afflicted.

Desired Outcomes:
At the conclusion of this activity, the learners will be able to:

Define and discuss the purposes and use of triage, in Mass Casualty incidents;
State the 4 Triage Categories;
Compare and Contrast Primary vs Secondary Triage;
Discuss the differences between “START” and “JumpSTART” Triage;
Apply these concepts to potential practice situations.

Dr. Millicent Wilson is an Emergency Medicine Physician and the Disaster Training Specialist for Los Angeles County’s Emergency Medical Services Agency. As a subject matter expert, Dr. Wilson provides education, training and strategic planning in all aspects of Bioterrorism and Disaster Preparedness. Dr. Wilson’s award winning work has been presented as ‘best practices’ in California, at state and also at national conferences. Dr. Wilson is an on-call Physician for the Los Angeles County Medical Alert Center serving a county of approximately 10 million residents. In addition to writing disaster preparedness policy for this large county, Dr. Wilson is the Disaster Chair for the American Academy of Pediatrics, AAP, local Chapter 2. She also serves on numerous local, state and national committees including the Bioterrorism Hospital Preparedness Planning Committee, the Pediatric Readiness Project and the Mass Medical Care clinic workgroup for the CDC.
CME Activity Flyer (PDF)

Trauma Journal Club
2017-08-18 07:30 - 08:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
By Invitation Only

The Frequency and Impact of Stress and Burnout and Other Factors Affecting Physician Attitudes, Behaviors, and Patient Care
2017-08-18 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Alan H. Rosenstein, MD, MBA, Practicing Internist and Consultant in Physician Behavioral Management, San Francisco, CA
presented by Alan H. Rosenstein, MD, MBA

Physicians are trained to provide best patient care. It takes years of dedicated time, effort and commitment, and the reward is the joy of practicing good medical care. But the changing nature and complexity of today’s health care environment is increasing physician levels of frustration, anger, cynicism, and more, leading to high levels of stress and burnout that has negatively impacted physician attitudes and behaviors toward patient care. We must recognize the seriousness of this issue and provide the necessary support and assistance to help physicians thrive and succeed in medical practice.

Desired Outcomes:

Gain a better understanding of the timing, incidence, causes, and impact of stress and burnout on health care practitioners;
Discuss the negative impact of stress and burnout on attitudes and behaviors that can adversely affect care relationships, satisfaction, patient safety, and quality of care;
Learn how to develop effective strategies to address stress and burnout and implement programs designed to enhance professional behaviors, staff satisfaction, and well- being;
Discuss the importance of collaborative strategies for early intervention geared to help health care professionals attain a healthier more satisfying personal and professional life.

ARU Grand Rounds: Rehabilitation for Systemic Lupus Erythematosus – Role and Efficacy
2017-08-21 12:00 - 13:00 UTC | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Yashaar Chaichian, MD, Clinical Assistant Professor, Division of Immunology & Rheumatology, Stanford University Medical Center
presented by Yashaar Chaichian, MD
Dr. Yashaar Chaichian was born in Lansing, Michigan. He completed his training and obtained his medical degree with Distinction in Research from the University of Iowa. After completing an internal medicine residency at the University of Wisconsin, Madison, he served as the primary care chief resident at the William S. Middleton Memorial VA Hospital in Madison. He then completed his fellowship training in rheumatology at the University of Chicago. Upon his fellowship completion, he spent an additional year there as an advanced fellow and part-time clinical instructor of medicine before being recruited by Stanford University.
Currently, Dr. Chaichian is a Clinical Assistant Professor and the Director of the Lupus Clinic within the Division of Immunology & Rheumatology at Stanford University. He has recently helped establish, in collaboration with the Division of Maternal Fetal Medicine, a multidisciplinary conference at Stanford that centers on the evaluation and management of patients with lupus and other autoimmune diseases during pregnancy. His current research interests include the epidemiology of lupus, particularly as it relates to pregnancy outcomes. In addition, he has plans to participate in several lupus clinical trials within the next year. Dr. Chaichian is a member of the American College of Rheumatology, and is board certified in rheumatology and internal medicine.
Desired Outcomes:

Appreciate the role that factors such as fatigue, cognitive impairments, pain, and decreased physical activity contribute to lower health related quality of life in patients with SLE;
Better understand the evidence base for use of rehabilitation in SLE and how this can translate into the clinical care of these patients.

CME Activity Flyer (PDF)

NMC Grand Rounds: Management of the Difficult Airway in Adults
2017-08-23 12:00 - 13:00 UTC | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Roger S. Proctor, MD, Anesthesiologist, Natividad Medical Center
presented by Roger Proctor, MD, Anesthesiologist.
Dr. Roger Proctor has spent most of his professional practice, before arriving at Natividad, at Highland Hospital in Oakland, California. In addition to a revolving door of Traumas, most of his patients had multiple co-morbidities and difficult airways were part of his daily routine.
With his talk, MANAGEMENT OF THE DIFFICULT AIRWAY IN ADULTS, he hopes that the care providers will understand that oxygenation and ventilation can be more than just intubation by direct visualization (direct laryngoscopy) in the difficult airway.
Desired Outcomes:

Recognize patients with a difficult airway when they present to you;
Implementing strategies to approach the difficult airway;
Be mindful of the difficult airway algorithm as well as the failed intubation algorithm;
Assess limitations: reliability, equipment, skill level, proficiency, as they will determine how you approach difficult and failed airways.

CME Activity Flyer (PDF)

Snake Bites
2017-08-28 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Susan Spano, MD, Assistant Clinical Professor, Health Science Series, Emergency Medicine, UCSF
presented by Susanne Spano, MD
North America is home to 25 species of poisonous snakes. Approximately 8,000 bites are reported in the United States annually, with approximately 2,000 delivered by venomous snakes. A bite from a venomous snake can be deadly, and should always be treated as a medical emergency. Venomous snake bites can produce localized pain and swelling, convulsions, nausea, and even paralysis. In the pediatric population, most snakebites occur in school-aged children and adolescents close to home during the summer months. As the season for snakes is just beginning, it is important for physicians to know the guidelines for treatment of snakebites.
Desired Outcomes:

Recognize the epidemiology of venomous snakebites in the southwest
Implement acute care for victims of rattlesnake bites
Choose the right antivenom (there are 2 FDA approved) and give the right amount
Administer inpatient and aftercare for patients suffering rattlesnake bites
Address common cultural misconceptions and/or beliefs surrounding snake bites and recognize when alternative treatments have been employed.

PEDS Grand Rounds: Scoliosis
2017-09-08 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
KALI R. TILESTON, MD,Clinical Assistant Professor, Pediatric Orthopaedic Surgery, Stanford Children’s Health && Sutter Health CPMC
presented by: Kali R. Tileston, MD,
Scoliosis

Scoliosis in adults is very different than scoliosis in children.
More than 600,000 patients seek physician care annually for this disorder.
Approximately 30,000 children have back braces to manage scoliosis.
Moderate to severe adolescent scoliosis is eight times more common in girls than boys.
A positive family history only increases the risk of adolescent scoliosis by twenty percent.

By understanding the differences of scoliosis conditions in children and adolescents, the most effective treatments can be implemented. Scoliosis is rarely painful, but if there is pain, it is important to look for other causes of the pain.

Desired Outcomes:

Review common causes of scoliosis: idiopathic, congenital, neuromuscular
Examine clinical findings of scoliosis
Discuss with patients and parents the appropriate treatment and management options for patients with scoliosis
Consider age and gender when evaluating for scoliosis in patients

CME Activity Flyer (PDF)

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)

Trauma Journal Club
2017-09-15 07:30 - 08:00, 2017-10-20 07:30 - 08:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States

Special Trauma Grand Rounds: Sepsis – A Leading Cause of Hospital Deaths
2017-09-15 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Daniel B. DiGiulio, MD,Clinical Instructor, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine
Sepsis is a serious medical condition caused by an overwhelming immune response to infection that can progress to shock, multi-organ failure and death. Severe sepsis affects approximately 750,000 Americans annually, with a mortality rate of ~28-50%. This educational activity will cover the epidemiology, pathophysiology, early diagnosis, and optimal treatment of sepsis and septic shock, including in vulnerable populations such as the elderly and immunocompromised.

Desired Outcomes:

Define the following terms: systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis and septic shock
Examine the pathophysiology of sepsis
Describe the priorities for treatment of sepsis
Recognize the changing epidemiology of sepsis with an increasing number of cases due to infections with Gram-positive bacteria
Cite prevention strategies to reduce sepsis and septic shock
Suspect sepsis over other conditions, particularly in older patients and patients with weakened immune systems
Recognize and diagnose sepsis in a timely and efficient manner

CME Activity Flyer (PDF)

ARU Grand Rounds: Neuromodulation: Basics, Indications and Current Technology
2017-09-18 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Vafi Salmasi, MD, Clinical Instructor of Anesthesiology and Pain Medicine, Stanford University
presented by Vafi Salmasi, MD, Clinical Instructor of Anesthesiology and Pain Medicine, Stanford University
Neuromodulation is one of more advanced tools that pain physicians apply to help patients with longstanding pain. Spinal cord stimulation was first used in 1960’s and its technology has evolved significantly over the course of past few decades. The key to its success is appropriate patient selection and setting expectations.
Desired Outcomes:
At the conclusion of the lecture the participants will be able to:

Review the basics of neuromodulation and available technology.
Understand the indications for spinal cord stimulation.
Examine the evidence of efficacy of this treatment.

CME Activity Flyer PDF

Trauma Grand Rounds: Domestic Violence
2017-09-21 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Carolyn J. Sachs, MD, MPH, Professor of Emergency Medicine, David Geffen School of Medicine at UCLA
presented by Carolyn J. Sachs, MD, MPH, Professor of Emergency Medicine, David Geffen School of Medicine at UCLA
Health care workers often encounter victims of domestic violence and may lack the necessary training to identify and treat them effectively. This lecture provides an overview of the general societal problem of intimate partner violence and specifically addresses the health care worker’s role in detection, treatment, documentation and referral of victims. Pros and cons of mandatory domestic violence reporting legislation are also presented.
Desired Outcomes:

Define domestic violence
Identify the profiles of victims
Identify the profiles of perpetrators
Use case history factors to identify domestic violence
Use universal screening to identify all domestic violence cases
Implement treatment strategies with traumatic injuries related to domestic violence
Document domestic violence cases in the ED
Appropriately follow the referral process in domestic violence cases

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)

NMC Grand Rounds: NMC & Patient-Centered Care: Our “PRIME” Direction-UPDATE
2017-09-27 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Debi H. Siljander, MD, Chief Clinical Transformation Officer, NMC; Charles R. Harris, MD, Chief Medical Information Officer, NMC; Jane A. Finney, CLS, MBA, CPHQ, CPPS, Consultant.
presented by: Debi H. Siljander, MD, Charles R. Harris, MD, and Jane A. Finney, CLS, MBA, CPHQ, CPPS.
Desired Outcomes:

Explain the concept of patient-centered medical home model care within Population Health Management including integration of Behavioral Health in Primary Care.
Describe recent accomplishments in Primary Care Redesign, Post-Acute Care Transitions, Specialty Care Redesign, Perinatal Services, Chronic Non-Malignant Pain Management and Patient Blood Product Management;
Apply patient- and family-centered care concepts.
List potential obstacles to patient-centered care.

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)

PEDS Grand Rounds: Child Abuse
2017-10-13 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Robert Morris, MD, Professor Emeritus, Mattel Children’s Hospital, David Geffen School of Medicine, UCLA
Speaker for this CME Activity is Robert Morris, MD
Child Abuse
Family physicians or pediatricians are likely to encounter victims of child abuse in their practice, and should be able to recognize its common presentations, as well as know how to evaluate and document these cases. A new study indicates that half of U.S. hospitals do not perform x-rays to look for fractures in children under the age of two who have been diagnosed with child abuse.
Desired Outcomes:

Recognize unusual presentations of child abuse
Identify factors leading to missed abusive head trauma
Know new modalities of diagnosing child abuse
Understand normal injuries of children
Know how to order x-rays in abuse situations.

Geared to Pediatrics, Family Medicine, and open to all other physician specialties and ancillary services.
CME Activity Flyer (PDF)

ARU Grand Rounds: Regenerative Medicine for Osteoarthritis – What is the Current Evidence?
2017-10-16 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Sean Colio, MD, Clinical Assistant Professor of Orthopedic Surgery, Physical & Rehabilitation Medicine, Stanford University School of Medicine
Speaker for this CME Activity is Sean Colio, MD
Regenerative Medicine for Osteoarthritis – What is the Current Evidence?
Regenerative medicine for Osteoarthritis is an emerging area that will influence the treatment of joint diseases in the future. It involves the use of biomaterials, cell therapy, and bioactive factors such as growth factors, drugs and small molecules, to regenerate damaged tissues. Dr. Colio will highlight the current evidence that informs on the direction in which this field is moving. This multidisciplinary field has been very active, with rapid development of new technologies.
Desired Outcomes:

Discuss the History & Biology of Platelet Rich Plasma (PRP)and Mesenchymal Stem Cells (MSC) for Osteoarthritis
Review the Clinical Applications of Platelet Rich Plasma (PRP)and Mesenchymal Stem Cells (MSC) for Osteoarthritis
Evaluate the Evidence for Platelet Rich Plasma (PRP)and Mesenchymal Stem Cells (MSC) in Osteoarthritis

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

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)

PEDS Grand Rounds: Special UCSF Celebration – EHR Integrated Pediatric Early Warning Signs
2017-10-30 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
ARPI BEKMEZIAN, MD, pediatric hospitalist. She serves as the Medical Director of Quality and Safety for the Division of Pediatric Hospital Medicine and as the Medical Director of Quality and Safety for the Benioff Children’s Hospital.
Speaker for this CME Activity is ARPI BEKMEZIAN, MD.
EHR Integrated Pediatric Early Warning Signs
Practice Gap:

Early recognition of clinical deterioration is an important goal of inpatient pediatric medicine. Delays in recognition and intervention increase morbidity and mortality.
Published early warning scores have limited discriminatory power.
The EHR has not been leveraged to facilitate accurate identification of patients at risk for deterioration.

Desired Outcomes:

Use of an early warning tool to accurately identify patients at risk for deterioration.
Improving the discriminatory power of the tool by enhancing its capacity to synthesize vital signs and vital sign changes, exam findings, medical risk factors, and biochemical markers.
Automation and full integration of the tool into the Electronic Health Record (EHR).
Integration of the tool into clinical care and use of the tool to facilitate standardized communication between providers.

Geared to Pediatrics, Family Medicine, and open to all other physician specialties and ancillary services.
CME Activity Flyer (PDF)

PEDS Grand Rounds: East of Salinas – A Film by LAURA PACHECO & JACKIE MOW
2017-11-09 12:00 - 13:30 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
A Film by LAURA PACHECO & JACKIE MOW
Discussion Moderated by: Kristin Burstedt Leonard, DO, Family Practice Medicine, NMC
Location: S.E.A. Conference Room
“East of Salinas takes us to the heart of California’s “Steinbeck Country,” the Salinas Valley, to meet a bright boy and his dedicated teacher — both sons of migrant farm workers. With parents who are busy working long hours in the fields, third grader Jose Ansaldo often turns to his teacher, Oscar Ramos, for guidance. But Jose is undocumented; he was born in Mexico. Like many other migrant children, he is beginning to understand the situation — and the opportunities that may be lost to him through no fault of his own. East of Salinas follows Jose and Oscar over three years: the boy is full of energy, smarts, and potential, while his teacher is determined to give back to a new generation of migrant children.”
Desired Outcomes:

Recognize the challenges that migrant farm worker families in Salinas face in their daily lives.
Integrate this increased awareness into improved patient communication and realistic treatment plans.

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

NMC Grand Rounds: Giving & Receiving Feedback
2017-11-15 12:30 - 13:30 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Our CME Speaker is: Brian M. Johnson, MD,
Associate Program Director, Contra Costa Family Medicine Residency, Martinez, California, Director, UCSF Family Medicine Faculty Development Fellowship, San Francisco, California
All physician teachers constantly engage in giving and receiving feedback. It is one of the most important things we do in helping learners, as well as a powerful way for us to grow as teachers. This activity will facilitate a workshop designed to help us all get a bit better at these vital faculty skills.
Desired Outcomes:

Describe the value feedback through the lens of learning trajectories
Describe the difference between formative and summative feedback.
Recognize the ARTful and BEST frameworks for giving feedback.
Ask for feedback (they actually want)

CME Activity Flyer PDF

Guillain-Barre Syndrome
2017-11-16 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Sarada Sakamuri, M.D. Associate Director, Neuromuscular Medicine Fellowship Clinical Assistant Professor of Neurology Stanford University School of Medicine
Presented By: Sarada Sakamuri, M.D.
Location: S.E.A. Conference Room
Guillain-Barré Syndrome (GBS) is a disorder in which the body’s immune system attacks part of the peripheral nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs. In many instances the symmetrical weakness and abnormal sensations spread to the arms and upper body. These symptoms can increase in intensity until certain muscles cannot be used at all and, when severe, the person is almost totally paralyzed. In these cases the disorder is life threatening – potentially interfering with breathing and, at times, with blood pressure or heart rate – and is considered a medical emergency.
Desired Outcomes:

Understand the immunologic basis of GBS
Recognize typical signs, symptoms, and laboratory and electrophysiological findings of GBS
Utilize appropriate treatment and supportive care in patients with GBS

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

ARU Grand Rounds: Stroke Recovery
2017-11-20 12:00 - 13:00 (America/Los_Angeles) | Natividad Medical Center, 1441 Constitution Blvd, Salinas, CA, 93906, United States
Paul George, MD, PhDAssistant Professor of Neurology and, by courtesy, of Neurosurgery at the Stanford University Medical Center
Speaker for this activity: Paul George, MD, PhD
Location: Natividad Conference Room
Stroke is the leading cause of disability in the United States, drastically disrupting the lives of stroke survivors and their caretakers. Unfortunately, because of tight therapeutic time requirements, the majority of stroke patients are not eligible for the current medicines or interventions. Current stroke recovery therapies remain limited. This lecture will address the gap between existing therapies and current research topics that may improve recovery for stroke patients.
Desired Outcomes:

Incorporate investigative studies into improving stroke recovery with current stroke rehabilitation practices.
Integrate recent biotechnology and stem cell advances into current knowledgebase which may affect standard clinical practice for stroke patients in he future.

CME Activity Flyer PDF
