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December 29, 2017 - No Grand Rounds - winter break

December 22, 2017 - No Grand Rounds - winter break

December 15, 2017 - "Resilience Building Strategies and Resources for Health Professionals"
Speaker: Sydney Ey Ph.D. Professor Dept of Psychiatry OHSU Associate Director OHSU Resident and Faculty Wellness Program

Objectives: 1) Describe national and local efforts and resources to reduce burnout and suicide risk among health professionals 2) Identify your personal signs of stress and one source of strength to draw upon 3) Describe two strategies to replenish/recharge 4) Practice healthier ways of thinking with self-compassion and cognitive behavioral tools.

Handouts: CME_121517_EyS

December 08, 2017 - "Antibiotic Stewardship"
Speaker: Kurt B. Stevenson, M.D., MPH Antimicrobial Stewardship Program Wexner Medical Center; Professor Medicine and Epidemiology Colleges of Medicine and Public Health The Ohio State University

Objectives: 1) Demonstrate an awareness of the risk factors and incidence of antibiotic resistance, 2) Review how to prescribe antibiotics cost-effectively and appropriately to prevent resistance, 3) Educate on limiting use of broad-spectrum antibiotics and utilize targeted restriction of antibiotics, 4) Discuss other measures to prevent antibiotic resistance, 5) Discuss documenting the impact and outcome data of antibiotic stewardship, 6) Consider racial, cultural and socioeconomic factors in antibiotic stewardship.

Handouts: CME_120817_Stevenson

December 01, 2017 - No Grand Rounds

November 24, 2017 - No Grand Rounds - Thanksgiving

November 17, 2017 - "Genetics and the New Classification of Connective Tissue Disorders"
Speaker: Osvaldo A. Schirripa, MD, MS, Central Oregon Clinical Genetics Center

Objectives: 1) Review basic understanding of Genetics 2) Review the recent March 2017 Classification of Connective Tissue Disorders with focus on Hypermobile Ehlers-Danlos Syndrome. 3) Provide examples of cases including evaluation, diagnosis, genetic testing, care and management.

Handouts: CME_111717_Schirripa

November 10, 2017 - TRAUMA CME “An Update on Spinal Cord Injuries”
Speaker: Graham Creasey, M.D. Paralyzed Veterans of America Professor of Spinal Cord Injury Medicine Stanford University School of Medicine

Objectives: 1) Describe the pathophysiology, etiology, and epidemiology of spinal cord injury, including histologic changes that occur following trauma. 2) Describe the various modalities used to identify different traumatic conditions. 3) Cite methods of quickly stabilizing and managing patients with spinal cord injuries. 4) Identify possible complications that may occur with spinal cord injuries.

Handouts: CME_111017_Creasey

November 03, 2017 - "Challenges of the Electronic Health Record, including Increasing Liability Claims"
Speaker: Sonny Nguyen, JD,RRT,CPHRM, Senior Director, Patient Safety & Risk Management, NW Region, The Doctors Company

Objectives: 1) Realize that the EHR is at “two-edged sword’ in that it both increases and decreases the risk of patient injuries, depending on how it is used by the user. 2) Appreciate that the claims of EHR-related patient injuries have more than doubled in the past 3 years.3) Understand that it is a universal problem, on all medical specialties and locations where the EHR is utilized. 4) Inform how HER-related patient injury claims can be reduced, both personally as a user and collaboratively as a community of users.

Handouts: CME110317NgygenPresentationBWHOs

November 03, 2017 - "Coping with the Electronic Health Record (EHR)"
Speaker: Roger McKimmy, MD Past Vice Chair, Oregon Medical Board; Oregon Urology Institute, Eugene

Objectives: 1) Appreciate that the EHR is not a “foe’ but a friend that can assist in helping care for patients (and not just track and justify billable entities). 2) Review and realize the specific errors practitioners make in using the EHR. 3) Explain how EHR-related errors can be avoided, both personally as a user and collaboratively as a community of users.

Handouts: CME_110317_McKimmyEMR_GR_HOs

October 20, 2017 - "Training Physicians for the Future US Health Care System"
Speaker: Dr. Tracy Bumsted, Associate Dean for Undergraduate Medical Education, OHSU

Objectives: 1) Appreciate the fundamental problems that are associated with our current system as learner’s transition into residency programs 2) Understand the value of providing unfiltered and accurate information to those responsible for guiding future learning 3) Compare and contrast different dashboards and reports that could be used to hand off learners as they transition to the next level.

Handouts: CME_102017_HOsBumstedEducationUpdateDOM

October 13, 2017 - "Practical Pain Management Tips for Busy Practitioners"
Speaker: Gregory L. Holmquist, PharmD, CPE; Pain and Palliative Care Specialist, director and owner Palliative Care Strategies Seattle, WA

Objectives: 1) Assess the current state of pain management in your facility 2) Provide overview of Best Practices for Hospital Pain Management 3) Coach staff on how to have difficult conversations about pain management with patients 4) Develop a strategy for systems-level management of pain medications.

Handouts: CME_101317_HOs_Holmquist_PracticalPainManagementTips

October 06, 2017 - "Hypertension: Management in the Outpatient Setting"
Speaker: Mark Backus M.D. FACP, Cascade Internal Medicine Specialists

Objectives: 1) Review up to date blood pressure goals for hypertensive patients 2) Identify ways to improve blood pressure control 3) Illustrate the proper body position for taking blood pressure 4) Identify strategies to improve blood pressure control 5) Identify patients that require referral or special testing for their hypertension 6) Explain the implications of the SPRINT blood pressure study.

Handouts: CME_100617_HOsBackus_Hypertension

September 29, 2017 - “PSA: The Worst Best Test Available”
Speaker: Matt Ashley, MD, Bend Urology Associates

Objectives: 1) Describe how to use PSA in the primary care and specialty setting 2) Review the recently changed USPSTF recommendations on PSA screening 3) Explain about new diagnostics that improve PSA accuracy 4) Discuss how changes in prostate cancer treatment affect screening strategies

Handouts: CME_092917_Ashley

September 22, 2017 - "Evidence-based Decision Support at the Bedside, what are the best resources"
Speaker: George Sarka, MD., MPH, FACP, FACR, Associate Clinical Professor of Medicine, David Geffen School of Medicine at UCLA

Objectives: 1) Augment the participant’s understanding of the terminology involved in a medical literature review and evidence-based medicine. 2) Assist the participant in becoming an effective and efficient user of medical literature and how to do a MEDLINE Search. 3) Analyze what is involved in a medical literature review. 4) Promote what questions are important in the evaluation of a clinical medical study. 5) Improve the participant’s skills in discerning what provides solid evidence-based medicine using primary and secondary literature review and where to find such information including pre-appraised or summarized evidence in the form of systematic reviews, meta-analyses, guidelines, etc.

Handouts: CME_092217_EBD_SupportBedsideBestResources

September 15, 2017 - "Breaking Bad or Breaking Good? Cannabis Consequences and Potential Medical Use"
Speaker: Steven Wright, MD, FAAFP, FASAM, Littleton, CO

Objectives: 1) Describe the basic physiologic and neurophysiologic effects of cannabis 2) List the major evidence-based negative consequences of cannabis use 3) Outline the potential evidence-based medical uses of cannabinoids 4) Apply a structured approach to recreational and medical use of cannabis which focuses on both safety and efficacy

Handouts: CME_091517_HOs_WrightCBBreakingoodBreakinbad

September 08, 2017 - "Update in Outpatient Medicine"
Speaker: Robert Gluckman, MD, Internal Medicine Specialist; Chief Medical Officer, Providence Health Plans

Objectives: 1) Review the frequency of medication non-adherence in the management of chronic conditions 2) Describe the revised USPTF Lipid guidelines for primary prevention of cardiovascular disease 3) Identify the gap between guidelines and practice for prescribing anticoagulants in patients with Atrial Fibrillation

Handouts: CME_090817_Gluckman_UpdateOutptMed

September 01, 2017 - No Grand Rounds - Labor Day Weekend

August 01, 2017 - No Grand Rounds for the month of August - Summer Break

July 28, 2017 - No Grand Rounds - Medical Staff Meeting Bend

July 21, 2017 - "Tobacco Cessation, E-Cigarettes and Hookahs"
Speaker: Amy V. Lukowski, PsyD, Clinical Director, QuitLogix, the tobacco cessation and disease management program at National Jewish Health in Denver , CO

Objectives: 1) Discuss pharmacologic options for tobacco cessation. 2) Review safety considerations for e-cigarette and hookah use.

Handouts: CME_072117_TobaccoCessationECigarettesHookahs

July 14, 2017 - "Intraoperative Radiotherapy with Mobile Units"
Speaker: Charles R. Thomas, Jr., MD, Professor and Chairman, Department of Radiation Medicine, Oregon Health and Science University

Objectives: 1) Distinguish between radio therapy and IORT, 2) Analyze the steps involved in the IORT Process, 3) Review recent studies and journal articles about the effectiveness of IORT compared with traditional radio therapy.

Handouts: CME_071417_Bend_IORT_HOs_presentation

July 07, 2017 - “Inpatient Glycemic Management”
Speaker: Bethany Klopfenstein, MD Assistant Professor of Medicine, Division of Endocrinology, Diabetes and Clinical Nutrition, School of Medicine, Oregon Health & Science University

Objectives: 1) Review American Diabetes Association best practice recommendations for inpatient diabetes care 2) Identify appropriate use of basal, prandial, and correctional dose insulin 3) Glycemic targets for hospitalized patients

Handouts: CME_070717_InpatientGlycemicManagementBend

June 23, 2017 - “Dementia in Older Adults”
Speaker: Teepa Snow, MS, OTR/L, FAOTA, Independent Consultant and Trainer Positive Approach, LLC

June 16, 2017 - "Compassion Fatigue: The Road Leading To Burnout"
Speaker: Richard S. Miller MD, FACS, Professor of Surgery Chief, Division of Trauma and Surgical Critical Care Vanderbilt University Medical Center Nashville, TN

Objectives: 1) Define and differentiate Burnout, Compassion Fatigue, and Primary Traumatic Stress 2) List the symptoms of compassion fatigue, 3)Describe the Compassion Fatigue Process 3)Identify tips for Managing Compassion Fatigue 4) Name and Discuss the ABC’s of Prevention: Awareness, Balance, and Connections.

Handouts: CME_061617_HOs_MillerR_CompassionFatigue

June 09, 2017 - “Multi-Disciplinary Team Communications and Effective Hand-offs”
Speaker: Lauren Destino, MD, Assistant Medical Director, Pediatric Hospitalist Program, Associate Medical Director of Acute Care Units Lucile Packard Children's Hospital Clinical Associate Professor Stanford University School of Medicine

Objectives: 1) Define a “hand-off,” and describe the different types of hand-offs that occur within a hospital 2) Identify problems with hand-offs 3) List the negative effects of poor patient hand-offs 4) Explain how improved communications on multi-disciplinary teams positively affect patient outcomes.

Handouts: CME_060917_Destino_MultiDiscTeamComm

June 02, 2017 - “Multi-System Organ Dysfunction Syndrome (MODS), the Role of Uncontrolled Infection”
Speaker: Carmen Mikacenic, MD, Assistant Professor of Pulmonary and Critical Care, University of Washington

Objectives: 1) Describe the Systemic inflammatory response syndrome (SIRS) and MODS, 2) Explain the pathophysiology of MODS, 3) Define the dysfunction of organs effected by MODS, 4) Discuss the epidemiology and prognosis, 5) Identify the recommended lab workups and imaging needed for differential diagnosis, 6) Describe surgical drainage and Debridement.

Handouts: CME_060217_Mikacenic_Handouts_MultipleSystemOrganFailure

May 26, 2017 - No Grand Rounds - Memorial Day Weekend

May 12, 2017 - Trauma “Natural Disaster or Terrorism, How Prepared Can You Be?”
Speaker: Marc Cote, DO, Assistant Dean for Clinical Education, Chair of Clinical Medicine, Chief and Associate Professor of Internal Medicine, Pacific Northwest University of Health Sciences

Objectives: 1) Approach to preparing your family, yourself and your institution to respond to disasters and active shooters. 2) List various physician roles in communities and hospitals preparing and responding to a natural disaster or terrorism. 3) Identify various national data sources for training your hospital and first responders.

Handouts: CME_051217_Howpreparedcanyoube_Cote

May 05, 2017 - "Post ICU syndrome and muscle loss prevention"
Speaker: Daniel Hagg, MD, Medical Director ICU St. Charles Health System

Objectives: 1) Review the effect of ICU care on muscle loss and outcomes 2) Educate about the post intensive care syndrome 3) Inform how advances in ICU training and rehabilitation can translate outside of the intensive care unit.

Handouts: CME_050517_Hagg

April 21, 2017 - Trauma "Concussion Management Update"
Speaker: Kevin Guskiewicz, ATC, PhD; Dean – College of Arts and Sciences from University of North Carolina

Objectives: 1) Describe the latest diagnostic approaches to concussion, 2) Define appropriate treatments of rest and return to activity, 3) Review the role of concussion in chronic traumatic encephalopathy.

Handouts: CME_042117_Guskiewicz_HOs_UpdateConcussionPreventionConcussionManagement

April 14, 2017 - "American Osteopathic Association guidelines for osteopathic manipulative treatment (OMT) for patients with low back pain"
Speaker: Brandon Isaacs, DO, FAAFP, Professor, Pacific Northwest University of Health Sciences, Yakima, WA

Objectives: 1) Explain the osteopathic philosophy, 2) Review the American Osteopathic Association guidelines for osteopathic manipulative treatment (OMT), 3) Discuss the benefits of OMT treatment vs. traditional treatment methods, 4) Explain the cost/benefit of OMT.

Handouts: CME_041417_Isaacs_HOs_AmericanOsteopathicAssocGuidelines

April 07, 2017 - "Systemic Lupus Erythematosus (SLE) Workup"
Speaker: Heather Hansen, MD, Rheumatology St. Charles Health System

Objectives: 1) Identify the presenting signs and symptoms of lupus, with a special focus on presentations and prevalence in minority populations 2) Utilize the ACR's criteria for classification of SLE to evaluate and refer a potential lupus patient to a rheumatologist 3) Facilitate co-management of a lupus patient with his/her rheumatologist, with special attention to medication adherence, monitoring for adverse effects, and laboratory and symptom monitoring, especially in situations where the rheumatologist is geographically distant 4) Identify and manage lupus-specific preventive care concerns, including vaccinations, cardiovascular health, fertility, and long-term consequences of medications.

Handouts: CME_040717_HansenH_DemystifyingSLE_HOs

March 24, 2017 - "Increase in Mortality Among U. S. Middle-Aged, White, Non-Hispanic Americans, 1999-2013"
Speaker: George Conway, MD, MPH Health Services Director Deschutes County

Objectives: 1) Recognize these co-morbidities in patients who may fit this profile, 2) Conduct depression and substance abuse screening, 3) Connect patients with local and community resources to help support the patients’ many needs, and 4) Follow the patient’s progress.

Handouts: CME_032417_Conway_IncreaseMortalitystchasgac

March 17, 2017 - “Best Practices in Inter-Professional Communication”
Speaker: G. Jay Westbrook, M.S., R.N., CHPN, Clinical Director Compassionate Journey

Objectives: 1) consistently integrate the tools & principles of Ethical Communication 2) employ communication techniques that engage, empower, & educate peers 3) articulate differences between communication tools for patients & for colleagues 4) leverage the power of questions & stories in winning hearts & minds 5) articulate the importance of knowing on which side of a door the hinges are located.

Handouts: CME_031717_WestbrookHOs_CommunicationBestPractices

March 10, 2017 - TRAUMA 'Wound Care and Limb Salvage: A Team Approach'
Speaker: Jason Jundt, MD, Vascular Surgery BMC

Objectives: 1) Introduction to St. Charles Wound Care Services 2) Wound care history 3) Identification of common wounds and their causes 4) Basic wound management 5) Outpatient wound care and when to refer to a specialist 6) Inpatient wound care and when to refer to a specialist 7) Future of wound care at St. Charles.

Handouts: CME_03102017_Jundt_CentralORWoundCareCenterHOs

March 03, 2017 - "Preventing A Chronic Disease by Management of Pre-Diabetes"
Speaker: Eden M. Miller, DO & Kevin T. Miller, DO, High Lakes Health Care

Objectives: 1) Analyze the Epidemiological Data of Pre-Diabetes in US and globally, 2) Describe the genetic predisposition and predictors of Diabetes Mellitus, 3) Describe the importance of earlier identification of glucose intolerance, 4) Define the definition of Pre-Diabetes, 5) Review the 11 features of Diabetes, 6) discuss the lifestyle interventions for the prevention of Diabetes Mellitus, 7) Advise on appropriate pharmacological interventions for the prevention of Diabetes.

Handouts: CME_030317_MillerPrediabetesGrandRounds

February 24, 2017 - TRAUMA “Current Management of Hip Fractures in the Elderly and Young Adult Patient"
Speaker: David Brown, MD, Orthopedic surgeon The Center

Objectives: 1) Differentiate treatment and management strategies for Elderly vs. Young Adult patients with Hip Fractures. 2) Review and understand current guidelines for management of hip fractures in elderly patients 3) Discuss proper evaluation, treatment and management of hip fracture patients 4) Improve communication and care between multidisciplinary care team members.

Handouts: CME_022417_BrownHipFractureLecture

February 17, 2017 - "Diagnosis and Treatment of Pediatric Eating Disorders"
Speaker: Dr. Naghmeh Moshtael, Medical Director of the Kartini Clinic

Objectives: 1) Identify signs and symptoms of eating disorders in children and adolescents less than 14 years 2) Discuss age appropriate treatment options with families of children and adolescents suffering from eating disorders 3) Gain further knowledge/awareness of statewide treatment options for children and adolescents suffering from eating disorders.

Handouts: CME_021717_Moshtael_DxTXPediatricEatingDisorders

February 10, 2017 - "Pertussis and Influenza with a Focus on Pregnant Women"
Speaker: Judy Guzman, DO, Professor of Pediatrics/Infectious Diseases OHSU

Objectives: 1) Review the clinical characteristics of pertussis and seasonal influenza 2) Educate on the recent epidemiology of both diseases 3) Discuss how to recommend effective disease prevention strategies to pregnant women and their newborns, including immunizations and chemoprophylaxis.

Handouts: CME_021017_GuzmanTdapFluPregnancy_HOs

February 03, 2017 - "An Update from the World of Snoring"
Speaker: Natalia Usatii, MD, Sleep Specialist, St. Charles Sleep Center

Objectives: 1) Identify new diagnostic modalities for sleep apnea, 2) Discuss new treatments for sleep apnea, 3) Sleep deprivation resulting in obesity, insulin resistance, psychiatric changes between adults and adolescents who are sleep deprived.

Handouts: CME_020317_GR_Usatii _HOs

January 27, 2017 - "Osteoarthritis Update - What Can We Do?"
Speaker: Michael L. Caravelli, MD Orthopedic Surgeon The Center: Orthopedic and Neurosurgical Care & Research

Objectives: 1) Discuss the causes of degenerative arthritis, and the impact of new techniques and technologies.

Handouts: CME_012717_Caravelli_HOs_BW

January 20, 2017 - "Advances in Catheter-Delivered Heart Valves"
Speaker: Matthew Slater, MD; Cardiothoracic Surgery St. Charles Medical Center

Objectives: 1) Review the impact that valvular heart disease has on patient quality of life and survival. 2) Explain the prevalence and incidence of valvular heart disease and how changing demographics will affect this. 3) Educate on the transcatheter technologies (aortic and mitral) that are currently available to treat valvular heart disease in the united states. 4) Illustrate the benefits and risks of transcatheter technology for treating aortic valve disease and compare transcatheter (TAVR) and open surgical approaches (SAVR). 5) Expand on the key components of working up patients for transcatheter valve procedures including patient screening, risk assessment and pre-procedure cardiovascular imaging.

January 13, 2017 - TRAUMA CME "Damage Control Resuscitation”
Speaker: Michael Woll, MD, St. Charles General Surgery

Objectives: 1) Review the pathophysiology of the lethal triad and the principles of Damage Control Resuscitation (DCR) 2) Explain the early indicators for massive transfusion 3) Discuss optimal ratios of blood component transfusion 4) Educate on the complications of MTP and provide an update on the current trends and future directions.

Handouts: CME_011317_GR_HOs_DCR

January 06, 2017 - “What Can We Do about Hospital Associated Infections?”
Speaker: Thomas C. Cesario, M.D. Emeritus Dean and Professor of Medicine, Division of Infectious Disease UCI School of Medicine

Objectives: 1) Present incidence of hospital acquired infections 2) Discuss risk factors for hospital acquired infections. 3) Review strategies to reduce key hospital acquired infections.

Handouts: CME_010617_Cesario_HOs_NOSOCOMIAL