Medical Staff Newsletter
October 2018
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Interim Chief Medical Officer Appointed
Effective November 1, Todd Phillips, MD, will serve as Interim Chief Medical Officer at CMC. He will also continue in his role as the Vice President of Quality and Clinical Effectiveness.
We have engaged a search firm to identify talented physician leaders interested in this important role at CMC. Candidates will be presented to a selection Committee for consideration.
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New Cerner Antibiotic Time-Out Alert Beginning
October 30th, 2018
Antibiotic Time Out Alert
The Antibiotic Time-Out Review process will be implemented to ensure compliance with the CDC and Joint Commission requirements for antimicrobial stewardship.
An alert will fire, upon chart open, for the Physician for all patients that have been on antibiotic/s for 72 hours. This alert screen will provide all the information to facilitate decision-making including: microbiology reports (if available), lab results, therapeutic monitoring, temperature and active anti-infective orders.
One of 4 actions must be taken: Continue the antibiotic with no changes; Extend the duration-renew; Discontinue; Defer to another Physician/MLP. If deferred, the alert will keep firing on chart open, until an action is taken or the order expires.
Rationale:
Broad-spectrum antimicrobial therapy is often started empirically in hospitalized patients with uncertain diagnoses while diagnostic information is being obtained. However, often prescribers do not reassess the initial choice of antimicrobial or the continued need for it, once additional clinical and laboratory data becomes available. An antibiotic "time out" is a term used by the Centers for Disease Control and Prevention and is listed as a key intervention for improving appropriate antibiotic use. The idea is that the most responsible physician will reassess antimicrobial therapy based on the patient's current clinical status and at a point when culture results and susceptibilities would be available to better inform clinical decisions.
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New Medical Staff Web Site Now Available
No password required!
Now you can:
* Review Quarterly Medical Staff minutes for meeting credit
* Watch lectures for CME credits
* Access Medical Staff Office contact information & forms
* And much, much more!
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High Reliability Organization Journey Continues
As of October 19, 78.6% of required Medical Staff have attended an HRO presentation and an additional 5.1% of required Medical Staff are registered for an upcoming presentation.
You're Improving Safety at CMC, So We're Celebrating!
Thursday, November 1, 6 - 9 am, 11 am - 2 pm, 4 - 6 pm, High Tide Café
On October 16, CMC achieved an awesome milestone on our Safety Together journey - our 500th Good Catch! Enjoy a complimentary meal in appreciation of all you do.
Safety Tools Refresher
Letter Clarification
For sound alike words and letters, say the letter followed by a word that begins with the letter...
A Alpha H Hotel N November T Tango
B Bravo I India O Oscar U Uniform
C Charlie J Juliet P Papa V Victor
D Delta K Kilo Q Quebec W Whiskey
E Echo L Lima R Romeo X X-Ray
F Foxtrot M Mike S Sierra Y Yankee
G Golf Z Zulu
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Welcome Amy Lewis, BSN, RN, CEN, Director of Patient Care, Emergency Department
Amy Lewis, BSN, RN, CEN joined Community Medical Center on October 1 as the Director of Patient Care for the Emergency Department.
Amy received her Bachelors of Science in Nursing at Thomas Edison State University, and is studying for her Masters of Science in Nursing-Organizational Leadership from University of South Carolina. She has received her Lean Six Sigma Green Belt in Healthcare from Villanova University.
Amy joins us from the University Medical Center of Princeton where she most recently served as the Director of Patient Experience Coordinator and prior to that she served as the Administrative Coordinator. Before that Amy was an evening Assistant Nurse Manager in the Emergency Department at Virtua Memorial Hospital after being an RN in the Emergency Department. She has also worked at Wills Eye Surgery Center and Lourdes Medical Center in Burlington County.
Amy's professional accomplishments include Emergency Nurses Association, Physician Nurse Communication Group, Emergency Department Bariatric Lead, Six Sigma Yellow Belt, System Wide Stroke Committee, Good Catch/Great Save Committee, Patient Experience and Flow Committee, Intake Redesign Committee along with various licensure and certifications.
Her office is located in the Emergency Department and she can be reached at extension 12073 or
Amy.Lewis@rwjbh.org.
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CEO I Made A Difference Awards Celebrate Patient-Recognized Physicians
Congratulations to the following members of the Medical Staff who were recognized at this quarter's CEO I Made a Difference Awards. The awards are presented to physicians, employees and volunteers who have been mentioned in letters, surveys or social media posts from patients or visitors. More than 4,500 recognitions have taken place since the program began three years ago.
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Julia Appleman, PA
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Nikunj Mehta, MD
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Robert Arnold, MD
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Antonio Meily, MD
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Markintosh Barthelemy, MD
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John Merlino, DO
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Kate Bianchini, APN
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Girish Nair, DPM
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Marie Bonvicino, MD
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Yeshavanth Nayak, MD
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Alyssa Bozzett, PA
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John Page, PA
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Sumy Chang, MD
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Pratik Panchal, MD
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Margaret Chung, MD
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Vipul Parikh, MD
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David D'Ambrosio, MD
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Jane Park, MD
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Danna Dela Cruz, MD
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Yung Park, MD
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Paul DeMartino, MD
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Alexis Patrick, PA
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David Dickerson, MD
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Yebarna Rana, MD
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Dino Espineli, MD
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Adam Repole, MD
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Samuel Fekry, MD
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Matthew Rosenblum, PA-C
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Victor Ferlise, MD
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Asu Rustemli, MD
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Thomas Fowlie, MD
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Micaela Sager, PA-C
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Doug Gibbens, MD
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John Sarris, MD
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Isabel Guerrero, MD
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William Schulman, MD
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Rakesh Gupta, MD
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Sarah Schwartz, APN
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Shannon Hopkins, NP
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Joshua Schwarzbaum, MD
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Steven Ingato, MD
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Meredith Silverstein, PA-C
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Rajesh Iyer, MD
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Sanjiv Sobti, MD
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Naomi Jones, CRNA
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William Strazzella, DO
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Francis Kelly, MD
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Jose Suatengco, MD
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Alex King, MD
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John Sutherland, MD
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Erik Larsen, DO
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James Tanis, MD
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Walter Lewis, MD
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Joseph Triolo, MD
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Steven Lowry, MD
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Jonathan Weinberg, MD
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Anthony Marion, PA
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Maurice Weiss, MD
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Tittymol Mathew, MD
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Thomas Yu, MD
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Measures Implemented to Address the High Incidence of
Hospital Onset C.difficile
(as defined by the CDC)
- HAND HYGIENE (cleaning hands before entering and upon exiting a patient's room). Remember that C.difficile spores are not killed by alcohol-based hand sanitizer and hands must be washed with soap and water. While we do not have data on rates of hand hygiene for providers exiting the room of a patient with C.difficile, we do know from our secret observers that all staff (physicians, nurses, etc.) at CMC performs hand hygiene 62% of the time in September. Physicians performed hand hygiene 38% in the same time period.
- REDUCTION OF TESTING OF LOW RISK PATIENTS. Our current PCR testing methodology for C.difficile has a high sensitivity; therefore, a positive test can indicate C.difficile infection OR C.difficile colonization. In an effort to reduce false positive tests, the Infection Prevention Department continues to review orders for C.difficile testing. If the patient is low risk for C.difficile infection (no diarrhea, normal WBC counts) the ordering physician may be contacted to discuss the case and the need to proceed with testing or discontinue the order. Our internal data suggests that C.difficile infection is uncommon in patients with a normal or declining WBC count. Many of these colonized patients are being tested because of diarrhea secondary to other potential contributing factors; tube feedings, chemotherapy, other medications that cause increase in GI motility.
- ENVIRONMENTAL CLEANING AND SANITIZING Environmental Services implemented a program for ensuring the competency of the housekeeping personnel in the cleaning of the patient's environment. Through monitoring, the Department evaluates the cleaning of the patient's room which includes the bed, call bell, side rails, overbed table and bathroom fixtures. ATP monitoring is used to quantify the presence of microorganisms on surfaces. Currently 95% of selected high touch surfaces in the patient's room are appropriately cleaned. This year's initiative is expanding the program to the Emergency room, Radiology, Cath Lab and stretchers used by the Transport staff.
Any suggestions or recommendations to decrease the incidence of C.difficile at Community Medical Center would be appreciated.
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Robotic Surgery Program Educates Public
Over 100 people were in attendance at
Latest Advanced in Robotic Surgery on September 26 at the Captain's Inn in Forked River. Guests listened to physician lectures from Stephen Lowry, MD, Christopher Passariello, MD, and John Sutherland, MD about robotic surgery options available at Community Medical Center. At the end of the event, attendees had a chance to ask them physicians any questions they had about robotic surgery procedures during a Q&A.
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Changes to CMC Medical Staff
Andrew Assiamah, MD - Department of Anesthesiology
Stanislav Ganzman, MD - Department of Anesthesiology
Savan Ghetiya, MD - Department of Medicine, Internal Medicine
Christopher Godek, MD - Department of Surgery, Plastic Surgery
Moira Schieke, MD - Department of Radiology
Michael Steinberg, MD - Department of Radiology
Nagehan Uzun, DO - Department of Medicine, PM & R
Rina Goldberg, MD - Department of Neurology, EEG Reads
Aviva Kupershtok-Bojko, MD - Department of Neurology, EEG Reads
Andy Rodriguez, MD - Department of Neurology, EEG Reads
Leave of Absence
Thomas Pidduck, MD - Department of Ophthalmology - effective September 20, 2018
Sukhwinder Hundle, MD - Department of Medicine, Internal Medicine - effective September 25, 2018
Suman Jain, MD - Department of Pediatrics - effective September 21, 2018
Ziaulhaq Zia, MD - Department of Medicine/Nephrology - effective August 6, 2018
Thomas Fowlie - Department of Emergency Medicine - effective October 11, 2018
Resignations
Kamel Ghaben, MD - Department of Pediatrics, Neonatology - effective September 30, 2018
Lyndsay Hall, CNM - Department of Ob/Gyn - effective December 11, 2018
David Junkin, MD - Department of Orthopedics - effective September 21, 2018
Anoop Porwal, MD - Department of Medicine, PM & R - effective September 20, 2018
Bruce Coplin, MD - Department of Medicine, PM & R - effective September 24, 2018
Modification of Privileges
David Dickerson, MD - Department of Orthopedics - Addition of MAKO- Robot Surgery - Hip and Knee
David Vogel, MD - Department of Medicine - Change in section from Pulmonary to Internal Medicine
Hillary Fuirita, PA - Department of Surgery - Addition of Robot Assistant privileges
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Clinical Documentation Tip of the Month:
Specified Encephalopathy and Cause
- Altered mental status; confusion; acute disorientation; delirium when charted do not earn credit for any severity of illness or increase in length of stay.
- Specifying the type and cause of encephalopathy will increase patient length of stay and severity of illness to the patient.
- Specified Encephalopathy can be used to describe any diffuse disease of the brain that alters brain function (acute; toxic; metabolic; septic; hypoxic).
- To strengthen your documentation, please link the TYPE of encephalopathy to the underlying cause or condition.
- Example: "Metabolic Encephalopathy due to Hyponatremia"
- Many physicians will use the clinical terms delirium and encephalopathy interchangeable, but they are not
- Delirium represents a syndrome that indicates a disease; psychological disorder or abnormal condition and may not fully capture the severity of illness intended by the physician
Confusion, Altered mental status, AMS, Disorientation = Zero credit for your care
Specified type of Encephalopathy = Increase in length of stay; major co-morbidity; credit for the care you provide
For more information, contact Nancy Jobes, RNC, MSN at 908-814-7409, or the Clinical Documentation Team at x12805 or 732-557-2805.
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Update on Unavailable Medications
The Pharmacy publishes a weekly list of medications that are unavailable due to multiple reasons including national shortages.
Click here to view the list.
If you have any medication questions, call the Pharmacy at ext. 18048.
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Running with the Devils 5K Run & Fun Walk
Saturday, November 3,
Essex County South Mountain Recreation Complex, West Orange
Participants receive a shirt, free admission to Turtle Back Zoo for the day of the event, and prizes. Runners receive a finisher's medal!
Medical Staff Dinner Dance
Friday, November 30, Old Mill, Spring Lake
Medical Staff Elections will be held at the November 26th Quarterly Medical Staff Meeting
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The following CME programs are scheduled for October 2018 at Community Medical Center:
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11/1/2018
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"Opioids: Prescribing, Withdrawal and Medical Assisted Treatment"
12:00 pm - 1:00 pm
Auditoriums A, B & C
Lina Shihabuddin, MD
Chief Medical Officer, Behavioral Health Network,
RWJBarnabas Health
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11/15/2018
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"
Update on the Nose and Sinuses: Inside and Out"
Noon - 1 pm
Community Medical Center
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11/29/2018
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"To Be or Not To Be is Not the Questions: A Practical Guide to Difficult Conversations"
12:00 pm - 1:00 pm
Auditoriums A, B & C
Marianne Holler, DO
Medical Director, Hospice and Palliative Medicine,
VNA Health Group
*This program fulfills 1 hour of the mandatory End of Life requirement for re-licensure
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Annual & Quarterly Med Staff Meeting
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26-Nov
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6:00 PM
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Breast Steering Committee
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26-Nov
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9:00 AM
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CMC Board of Trustees
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29-Nov
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8:00 AM
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Credentials Committee
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19-Nov
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5:30 PM
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Critical Care Committee
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13-Nov
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8:00 AM
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Executive Committee
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6-Nov
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6:00 PM
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Family Medicine Dept.
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20-Nov
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8:00 AM
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GI Section
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26-Nov
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5:00 PM
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Health Information Management Committee
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28-Nov
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12:15 PM
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Med Staff Quality Council
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15-Nov
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7:30 AM
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Medicine Department
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15-Nov
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6:00 PM
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Medicine/Fam. Practice Peer QA Committee
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6-Nov
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8:00 AM
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Nephrology Section
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15-Nov
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5:30 PM
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Neurology Department
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28-Nov
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6:00 PM
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New Physician Orientation
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19-Nov
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4:00 PM
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OB/GYN Dept.
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15-Nov
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7:00 AM
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Ophthalmology Dept.
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26-Nov
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5:30 PM
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OR Advisory
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28-Nov
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7:00 AM
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Otolaryngology/Head & Neck Surgery Dept.
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26-Nov
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5:00 PM
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Pediatrics Dept.
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13-Nov
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12:00 PM
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Performance Improvement Council
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16-Nov
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7:30 AM
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Pharmacy & Therapeutics Committee
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27-Nov
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8:00 AM
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Physical Medicine & Rehab Section
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26-Nov
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5:45 PM
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Physician Dinner Dance
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30-Nov
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6:00 PM
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Podiatry Department
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26-Nov
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5:30 PM
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Podiatry Peer Review
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26-Nov
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5:00 PM
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Psychiatry Section
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20-Nov
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5:30 PM
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Pulmonary Section
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15-Nov
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5:00 PM
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Radiation Oncology Quality Assurance
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29-Nov
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12:30 PM
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Robotics Committee
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20-Nov
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7:00 AM
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STEMI Review Committee
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27-Nov
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6:00 PM
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Tumor Board - Breast
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12-Nov
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8:00 AM
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Tumor Board - Breast
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26-Nov
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8:00 AM
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Tumor Board - Colorectal
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16-Nov
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12:00 PM
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Tumor Board - Med Onc
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2-Nov
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12:00 PM
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Tumor Board - Neuro Oncology
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19-Nov
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8:00 AM
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Tumor Board - Thoracic
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9-Nov
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8:00 AM
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Tumor Board - Thoracic-
CANCELED
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23-Nov
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8:00 AM
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Urology Dept.
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7-Nov
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7:00 AM
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Utilization Review Committee
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28-Nov
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7:30 AM
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