********* INDEX ***********
New Appointments
Mishawaka
Plymouth
Resignations
Mishawaka
Plymouth
New Medical Staff Policy
Mishawaka
Plymouth
Medical Staff Meetings
Mishawaka
Plymouth
CME Schedule
SJRMC News
NEW APPOINTMENTS
Mishawaka
Michelle Bache, MD, Elkhart Emergency Physicians Inc. – Active staff membership and privileges in Emergency Medicine
George Kim, MD, Elkhart Emergency Physicians Inc. – Active staff membership and privileges in Emergency Medicine
Scott Ludwig, MD, Elkhart Emergency Physicians Inc. – Active staff membership and privileges in Emergency Medicine
John Rice, MD, Elkhart Emergency Physicians Inc. – Active staff membership and privileges in Emergency Medicine
Alison Robertson, DDS, SMBHC – Limited Active staff membership and privileges in Dentistry
Phillip Schafer, DO, Elkhart Emergency Physicians Inc. – Active staff membership and privileges in Emergency Medicine
Kelley Smith, MD, Elkhart Emergency Physicians Inc. – Active staff membership and privileges in Emergency Medicine
David VanRyn, MD, Elkhart Emergency Physicians Inc. – Active staff membership and privileges in Emergency Medicine
Katharine Withorn, DO, Elkhart Emergency Physicians Inc. – Active staff membership and privileges in Emergency Medicine
Sarah Bortone, NP, Kidney Care of Michiana, LLC – Nurse Practitioner in Nephrology
Lindsey Hora, DA, Granger Oral Surgery – Dental Assistant in Oral Surgery
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Plymouth
Michelle Bache, MD, Elkhart Emergency Physicians Inc. –Active staff membership and privileges in Emergency Medicine.
George Kim, MD, Elkhart Emergency Physicians Inc. – Active staff membership and privileges in Emergency Medicine.
Scott Ludwig, MD, Elkhart Emergency Physicians Inc. – Active staff membership and privileges in Emergency Medicine.
Mark Quiring, MD, Elkhart Emergency Physicians Inc. - Active staff membership and privileges in Emergency Medicine.
John Rice, MD, Elkhart Emergency Physicians Inc. - Active staff membership and privileges in Emergency Medicine.
Phillip Schafer, DO, Elkhart Emergency Physicians Inc. - Active staff membership and privileges in Emergency Medicine.
Kelley Smith, MD, Elkhart Emergency Physicians Inc. - Active staff membership and privileges in Emergency Medicine.
David VanRyn, MD, Elkhart Emergency Physicians Inc. - Active staff membership and privileges in Emergency Medicine.
Caesar Weston, MD, Elkhart Emergency Physicians Inc. - Active staff membership and privileges in Emergency Medicine.
Katharine Withorn, DO, Elkhart Emergency Physicians Inc. - Active staff membership and privileges in Emergency Medicine
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RESIGNATIONS
Mishawaka
Harold Bivins, MD – Active staff membership with privileges in Maternal Fetal Medicine
Brandon Churchman, PA – Licensed Advanced Practitioner with privileges as a Physician Assistant in Emergency Medicine
Ruth Conley, NP – Licensed Advanced Practitioner with privileges as a Nurse Practitioner in Hematology/Oncology
David Fellows, PA – Licensed Advanced Practitioner with privileges as a Physician Assistant in Emergency Medicine
Victor Jones, MD- Active staff membership with privileges in Radiology
Timothy Kragt, PA – Licensed Advanced Practitioner with privileges as a Physician Assistant in Emergency Medicine
Emily Nelson, PA – Licensed Advanced Practitioner with privileges as a Physician Assistant in Emergency Medicine
John Oren, MD – Affiliate staff membership with no privileges
Caitlin Vlaeminck, NP – Licensed Advanced Practitioner with privileges as a Nurse Practitioner in Orthopedics
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Plymouth
Nicole Borem, CRNA – AHP with privileges in Anesthesiology.
Victor, Jones, MD – Courtesy staff membership with privileges in Radiology
John, Kim, MD – Active staff membership with privileges in Ophthalmology.
Doug Pruitt, CRNA – Allied Health Provider with privileges in Anesthesiology
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NEW MEDICAL STAFF POLICY
Mishawaka
No new policies this month.
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Plymouth
No new policies this month.
If you would like to receive a copy of this document please call the Medical Staff Office at 948-5005
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MEDICAL STAFF MEETINGS
Mishawaka
February 27, 2015 – Credentials Committee, Board Room, 6:30 am
March 2, 2015 –Medical Executive Committee, Board Room 6 pm
March 4, 2015 – Integrated Leadership Team, Board Room, 7 am
March 10, 2015 – OB/GYN Department meeting, Board Room, 7 am
March 11, 2015 – Cardiovascular Peer Review Committee meeting, Board Room, 7 am
March 18, 2015 – Medical Staff Professional Practice Council, Board Room, 7 am
March 20, 2015 – Peripheral Vascular Peer Review Committee meeting, Board Room, 7 am
March 24, 2015 – Officers Meeting, CEO Conference Room, 7 am
March 25, 2015 – Otolaryngology Subsection meeting, Board Room, 7 am
March 27, 2015 – Credentials Committee, Board Room, 6:30 am
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Plymouth
March 13, 2015 – Full Medical Staff Meeting, Education Center, 12:00 noon
March 23, 2015 – Medical Executive/Medical Credentials Committee, Boardroom, 12:00 noon
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CME SCHEDULE
CMEs will be held in the SJRMC Mishawaka Education Center from 12:15 – 1:15 pm. Lunch will be provided. Direct questions to Continuing Medical Education at 574-335-1052. Video conference to Plymouth is available by contacting the Plymouth Medical Staff Office in advance at 574-948-5005.
March 4, 2015–Preventing Infection in the Immunocompromised Host, Preeti Malani, MD, Associate Professor of Medicine, Division of Infectious Diseases, University of Michigan Ann Arbor
March 18, 2015 – Imaging Update: Appropriate Exam Selection, Neuroradiology and Cardiac MRI, Steven Gerstler, MD, Jonathan McCrea, MD, Paul Shu, MD, Radiologists SJRMC
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SJRMC NEWS
Mishawaka – COO – Chris Karam
Chris presented an informational power point presentation on Daily Safety & Experience Brief. Daily safety huddles are being held at 10:00 am every day in the Emergency Conference Room.
`Mishawaka - CNO Report – Ken Hall
Ken stated that the Code White went well especially the transporting of employees to and from the hospital.
Mishawaka & Plymouth - CMO Report - Stephen Anderson, MD
Dr. Anderson stated Trinity Health is developing a Code of Conduct policy. Physicians will be asked to support it as a quality perspective.
Dr. Anderson stated the hospital will be developing clinical guidelines for treatment of delirium. A process is needed to assess patients and what medications to prescribe.
Blood transfusion utilization through December showed an increase in the percentage of units of packed red cells administered at a threshold below a hemoglobin of 7.0 increasing from a level of 19.4% prior to the change in threshold to a level of 26.6% in December. The total percentage of red cell transfusions ordered when the hemoglobin is greater than 8.0 declined from 39.3% to 29.1%. Changes in the Cerner ordering process for blood transfusions is detailed in the Informatics Newsletter that accompanies this issue.
The Physician Partnership Survey results were reviewed at the recent Mishawaka MEC meeting. Dr. Toth-Russell will head up a team of physicians and senior administrators that will study the results in depth and determine action plans and further communication with the medical staff. As noted in the Plymouth report, the Saint Joseph system has made strides in overall scoring and engagement in the past 4 years. Opportunities for improvement have been identified and are continuing to be addressed.
Plymouth - President and CNO/COO Reports – Loretta Schmidt and Tammy Awald
Loretta Schmidt reported that the Daisy and John L. Oliver Emergency Center project remains on time and on budget. The blessing and dedication is scheduled for September 24, 2015.
Access through exterior doors will be transitioning to a badging system through a phased process.
SJRMC Plymouth agreed to pilot The Joint Commission's draft Stroke Ready Certification standards. A mock survey was conducted with very positive outcomes. Plan to file a formal application on July 1, 2015.
Physician partnership survey scores have been received. The mean score of the Saint Joseph Regional Medical Center Inc. has increased over the last four years. SJ Plymouth ended in the 86th percentile ranking for standard overall score. An action plan is being developed with partnership of the MEC and medical staff leaders.
Plymouth Critical Care Collaborative Committee
A Critical Care Collaborative Committee has been formed and will oversee the quality of care rendered to critical care patients. Duties of the committee will include coordination and leadership of the activities of the Critical Care Unit and supporting programs for quality of care of patients, including design, implementation and monitoring of CCU patient care protocols and guidelines; evaluation and recommendation of new/upgraded technology; supervision of the quality of care and performance improvement initiatives; development of physician staff education plans and competencies; monitoring, documenting, and continually improving care provided to be evidence driven and to the latest standards of care.
NEW - SJRMC Medical Record Completion Policy – You can find this policy attached and at
In an effort to thoroughly communicate this new policy, we are including this information in this month's newsletter again.
Mishawaka and Plymouth recently modified policies for Medical Record Completion, which includes new time frames for completion. One thing to note is the inclusion of coding and documentation queries as items that require completion (usually a "no change" or a brief record update is all that is required.) The change in time frames will be implemented now, but the enforcement of time frames will not transition until June 1 in order to give clinicians time to adjust to the changes. (Suspension time frames under the previous policies will continue to exist and be acted on.) Suspension for incomplete records remains a rare occurrence at the Mishawaka and Plymouth facilities and something that both medical staff leadership and administration wish to avoid.
Ethics Consults
MISHAWAKA/ELM ROAD
Physicians that would like a member(s) of the Ethics Committee to meet with them or a patient/family about an ethical issue are asked to call the operator (574.335.5000) and make the request. The operator will contact the assigned member of the Ethics Committee who, in turn, will respond to the request within 24 hours or sooner if the request is urgent. If a physician wants to speak directly to the Ethics representative, please call the operator and she will page the representative.
PLYMOUTH
Physicians that would like a member(s) of the Ethics Committee to meet with them or a patient/family about an ethical issue are asked to call the on-call administrator and make the request. The on-call administrator will contact the assigned member of the Ethics Committee who, in turn, will respond to the request within 24 hours or sooner if the request is urgent. If a physician wants to speak directly to the Ethics representative, please call the on-call administrator and she will page the representative.
See the attached monthly INFORMATICS NEWSLETTER.
See the attached RX Review Newsletter.
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