1. < Cardiology/Epi

We all work very hard and often, the relationship between what we do and how we are rewarded seems transactional. I was reminded in the past weeks that for many in our community this is not necessarily the case.

EVACUATION  

Wednesday, December 28th was meant to be another routine day of GI procedures by our staff and gastroenterologists at the West Hills Medical Procedure Unit (MPU). As the team was prepping a patient for a procedure, they received notification from the LA Fire Department of the need to evacuate the building immediately, due to a hazardous waste spill. After evacuating the patient and staff, they learned that a non-UCLA affiliated gastroenterologist, practicing in a neighboring suite, was using an old esophageal dilator that eroded and spilled a pound of mercury which spread throughout the HVAC system. An incident such as this could have resulted in the cancellation of many appointments, but that was not the case under the leadership of Administrative Director Brooke Soudraha and Dr. Rimma Shaposhnikov.  

“Our staff are willing to do whatever we need to do for the patient. Staff are resilient and can deal with hits as they come without wavering. Our colonoscopy patients arrive prepped for their appointments and cancelling them would not be right. We do everything that we can to avoid that,” 

states Soudraha.

The West Hills MPU had to close for two weeks while crews worked on a full remediation of the premises. Patients were re-scheduled for their procedures to North Hollywood or other local Ambulatory Surgical Centers (ASC’s), until it was safe to return to West Hills on January 11th. However, normal operations at the West Hills location would only last for two days. On January 13th, at around 8 am, a construction crew accidentally hit the water main, shutting off water to the building. Staff had to immediately divert patients to North Hollywood again. Gastroenterologists, anesthesiologists, and the nursing staff from West Hills commuted to North Hollywood to avoid cancelling over 30 patients that day.

As if these calamities were not enough for the GI team, Mother Nature decided to test the resiliency of the GI division at our Santa Clarita/McBean MPU site. During the recent rainstorms, flooding caused water intrusion at this site. Over the next 4-6 weeks, you will see the Santa Clarita/McBean units working closely with neighboring community practices to ensure that patient appointments are not cancelled while repairs are being made. A special shout out to the many team members who ensure that we will continue to provide high-quality care to our patients despite these challenging circumstances.

Despite these travails, the team continued the necessary work that culminated in the South Bay MPU achieved AAAHC accreditation last week! Congratulations!

CENTRAL COAST FLOODING 

The recent rain also posted significant challenges for several other community practices, particularly those on the Central Coast who experienced severe flooding, street closures, and learned that it only takes 12-24 inches of rushing water to carry a car. Despite the challenges presented, practice leaders, faculty, and staff demonstrated exemplary leadership as they kept the clinics running and attending to patients until it was time to follow evacuation orders.  

According to Director of Ambulatory Services Lariza Johnson:  

“Montecito Manager Marina Amis-Garcia, along with Lead Physician Dr. Amanda Scott, quickly coordinated the efforts to finish the morning clinic and have the providers continue the afternoon clinic via telehealth. We moved the rest of the staff to our Ventura site to continue assisting the providers and answering urgent calls from patients. We are grateful to Laura Miller, manager at the Ventura site, and her supervisors for assisting and providing workspaces and phone lines for the staff. Melissa Claudio, LVN supervisor, provided much needed support for coordinating the staff and the changes in the workflows during this time. On Saturday, another storm rolled in (albeit a smaller one and no evacuation order). We had to close the Saturday walk-in clinic in the afternoon due to the current conditions of the road/area. Cheyenne Catalano, admin supervisor, stayed at the site in case patients call or show up in the clinic.”

Johnson adds that in San Luis Obispo the hematology-oncology team bravely stayed behind at their site to complete the infusion clinic schedule and coordinate future appointments for cancer patients. This team consisted of San Luis Obispo Site Manager Mandy Serrano, LVN Supervisor Alma Morales Perez, Oncology Infusion Registered Nurses Michele Adams and Michelle Oetman, along with Infusion Scheduler Elvira Figueroa.

KIND WORDS

I could share many more stories about how our faculty, trainees and staff go above and beyond the call of duty for our patients, and the DoM community. However, let me share a few words from patients and colleagues which capture the exceptionalism and commitment of our team.

SOME NEWS FROM THE HOSPITAL-BASED TEAM 

I am pleased to celebrate the members of the UCLA Heart Transplant Team who shared that in 2022, they performed 73 heart transplants, an increase from the prior year where the team performed 65 heart transplants. Kudos to Ali Nsair, MD and Abbas Ardehali, MD who continue to expand this lifesaving program for our patients. 

In case you missed it, last week we shared the news that leaders in the division of infectious diseases are taking on new leadership roles within UCLA Health and the department of medicine. I am pleased to announce that Dan Uslan, MD will assume the role of Chief Infection Prevention Officer at UCLA Health and Paul Allyn, MD will assume the role of Clinical Chief of the Division of Infectious Diseases at UCLA Health. Dr. Uslan and Dr. Allyn bring a wealth of experience into their new roles that will continue to expand our ability to care for patients at UCLA Health and beyond. Read the full announcement HERE.

The examples shared above reflect the broad reach of clinical services that the DoM renders to our community. The past five years have been a time of remarkable growth in community clinical services, led in large part by the DoM. The growth must continue, but it needs to be coordinated and strategic. I am a member the Ambulatory Strategic Planning & Oversight Committeewhich was established by UCLA Health with the goal of establishing an integrated and coordinated approach to strategic planning and development related to ambulatory care services in the community. A summary of the charge of the committee and the ambulatory strategic goals can be found HERE.

In brief, we seek to embark on a strategy in which there is coordination between departments and the health system as we establish new ambulatory programs, to ensure that ancillary services and referral capabilities are in place. We also seek to evaluate the competitive landscape, financial viability of new initiatives and determine optimal levels of physician and clinical staffing. There is strong representation of DoM faculty on this committee, that is chaired by Dr. Eve Glazier. Drs. Evelyn Curls, Adam Cavallero, Eric Curcio, Jeff Borenstein are members of the primary care workgroup. Drs. Ravi Dave, Dennis Slamon, Eric Esrailian are members of the specialty and ancillary workgroup. 

Dale 

P.S. To many members of our community who celebrated the Lunar New Year yesterday, let me wish you a happy year of the rabbit. I know that for many of you, your joy was tempered by the tragic events in Monterey Park on Saturday night. While there are many questions that remain to be answered, we are here to support you and there will be more communication forthcoming from the DoM. I share below one the greetings that I received yesterday morning, remaining hopeful.

---