The SGH Medical Staff has an opportunity! Audit results indicate that MD compliance in October 2010 was 89% and in November 2010 it fell to 69%.

Let's start 2011 with improvement!

Several members have requested one more clarification re: DNRs.

In the absence of a substitute decision-maker in a mentally incompetent patient, treatment may proceed for an emergency medical condition as long as the physician documents that such an emergency medical condition is present.

Policy 01829: Section III. TEXT, H.: In the case of a medical emergency, treatment may proceed without the patient's consent so long as no evidence exists to indicate that the patient or the patient's representative would refuse treatment (such as religious beliefs or a relative's statement regarding the patient's wishes).

1. the medical determination that an emergency exists shall be documented by the physician.

a. The physician shall not sign the consent form on behalf of the patient, but shall document in the medical record that an emergency exist.
b. The treatment provided shall be limited to that which is needed for the emergency condition.
c. The emergency exception is not applicable when a patient has validly refused treatment and the emergency arises because of this refusal.

The decision to suspend a pre-existing DNR order in such a case would need to be documented by the physician.

If the DNR order is suspended peri-operatively, an order needs to be written.

It would be prudent for the surgeon to discuss whether or not to suspend the DNR order peri-operatively with the anesthesiologist and/or other physicians involved in the care of the patient.

Since the surgeon is entering the postoperative orders, the resuscitation status must be reassessed and new orders written by the surgeon. The surgeon may consult with other physicians involved in this patient's care if he/she feels that it is necessary or may defer the resuscitation status assessment to the most responsible physician for the particular patient.

Which one are you?
A "well-seasoned" medical staff member or a relative "newby?"

PLEASE CHANGE YOUR CALENDAR!!!

General Medical Staff Meeting
March 17, 2011
rescheduled from March 15
5:30 pm Wine & H'ors doeuvres/6 pm Program
Main Auditorium
SPOUSES WELCOME

We're excited about this speaker!!! The Three Chiefs recently attended a COS Boot Camp and they knew you would enjoy one of the presentations so much that they invited the speaker to bring his thoughts about generational differences between our medical staff members to the entire medical staff! This will definitely stimulate some lively discussion.

Richard Corlin MD FACP

Dr. Corlin is the Past President of the American Medical Association (AMA) and Past President of the California Medical Association (CMA). He has also served as Speaker of the House of Delegates of both the AMA and the CMA and as Chairman of the Board of Audio Digest. He is in private practice as a gastroenterologist in Santa Monica, California.

• RSVP by return email- A Segway Tour of the art along Harbor Drive - Sunday, January 30, 2011, 1:30 pm - $69 per person
• Dancing with the Doctors - Friday, February 11 - 5:30 pm Hors d'oeuvres 6 pm Dancing Lesson
• Hike Horsethief Canyon - Sunday, February 13, details to follow
• Texas Hold 'um Tournament - Date to be Announced
• Family Bowling Night - Date to be Anounced

Call Lesley Bradley at 619-740-4145 for information on any event!

Are you interested in seeing a recently published issue of the E-Bulletin?