Norman Label, MD — Local Doc Makes Good

Norman Label, MD, and EPMG President, was awarded the Outstanding Service Award by CHW’s Mercy General Hospital Family Practice Residency Program for Emergency Room Attending Physician of the Year for 2008-2009.

Dr. Norman Label, FACEP, FAAEM, has served as president of Emergency Physicians Medical Group (EPMG) since 1998. Prior to the merger of EPMG and Sierra Pacific Emergency Medical Group (SPEMG) in 1995, he served as president of SPEMG from 1990 to the merger date. Dr. Label has served as a board member with both groups since 1984. He graduated from the Philadelphia College of Pharmacy and Science with a Bachelor’s of Science in Pharmacy. He later graduated from Jefferson Medical College of Philadelphia and completed his post-graduate studies in the United States Air Force. He served as flight surgeon in Southeast Asia in 1970. Dr. Label is board certified by the American Board of Emergency Medicine and the American Board of Family Medicine. Dr. Label is a Fellow of the American College of Emergency Physicians and a Fellow of the American Academy of Emergency Medicine.

Congratulations on this well-deserved honor, Dr. Label!

St Rose de Lima Rated First in Nevada

In the latest national report card of hospital rankings, HealthInSight, a nonprofit group in Las Vegas that monitors patient care quality and ranks hospitals using 25 criteria, placed St. Rose Dominican Hospitals Rose de Lima campus in first place for the State of Nevada.

The hospitals' scores, based on a scale of 100, indicate the consistency of standard procedures for serious health conditions that are reported to the federal government. The measurements are designed to assess a hospital's performance in the treatment of heart attacks and pneumonia, among others.

As pointed out by the executives of St Rose de Lima, the end result is undeniable and shows how hard the ED team has worked. EPMG recognizes Dr Lance Allgower, Site Director, and Dr Douglas Ross, site Quality Director, as well as all EPMG physicians of the St Rose team for their leadership and team approach to solving critical healthcare issues.

Lance Allgower, DO ED Site Director St. Rose Dominican Hospitals—de Lima Campus

Doug Ross, MD ED Quality Director St. Rose Dominican Hospitals

"Ross’ monthly education and case review process is simply outstanding." — JD McCourt, MD, ED Medical Director, UMC

The EPMG 2009 Quality Director of the Year award was presented to Dr. Ross Berkeley, University Medical Center, Las Vegas, in recognition of his outstanding contribution to the Quality Improvement of his Emergency Department and Hospital. Dr. Berkeley serves as Director of Quality Improvement and education for the ED at UMC and as Vice-chair of the UMC Quality and Patient Safety Committee. He is also Director of the Chest Pain Center at UMC and the EMS Medical Director of the College of Southern Nevada and Lake Mead National Recreation Area. He has served with EPMG since 2000. Dr. Berkeley received his medical degree from the University of California, San Francisco School of Medicine and completed his Emergency Medicine Residency at the University of Pittsburg Medical Center. He is board certified in Emergency Medicine.

The EPMG 2009 Medical Director of the Year award was presented to Dr. Rob Kozel, Methodist Hospital of Sacramento, in recognition of his outstanding Leadership and Dedication to his Department, Physicians, and Patients. Dr. Kozel serves as the Director of Emergency Medicine at Methodist Hospital in Sacramento, California. He has been an EPMG physician since 1998. Dr. Kozel earned his medical degree from the University of Nevada School of Medicine in Reno, Nevada, and performed internship and residency in Emergency Medicine at the University of Maryland Medical System in Baltimore, Maryland. He is board certified in Emergency Medicine.

"Rob has been instrumental in redesigning the ED flow and improving patient care metrics at Methodist ED." — Norman Label, MD, EPMG President

"Robert’s participation in education, philanthropy and simple acts of kindness every day make this award readily deserved." — Josh Rubin, MD, FACEP, EMP President, WR

The EPMG 2009 Physician of the Year award was presented to Dr. Robert Kezirian, Children’s Hospital Central California, in appreciation of his outstanding Patient Satisfaction and Patient Care. Dr. Kezirian currently serves as the Pediatric Residency Program Director and Clinical Department Chair for the ED at CHCC. He has been with EPMG since 2004. Dr. Kezirian earned his doctorate in medicine from the Universidad Autonoma de Nuevo Leon in Mexico and completed his medical training at Valley Medical Center and Valley Children’s Hospital in Fresno, California. He is board certified in Pediatrics and Pediatric Emergency Medicine.

CHCC Physicians Nominated

The Board of Trustees of Children’s Hospital of Central California annually nominates for the Meritorious Service Award a member of the Medical Staff who has dedicated him or herself to educating nurses and other hospital staff and/or the community. This year, the nomination goes jointly to Drs. Robert Kezirian and Steven Foster. Said of Drs. Kezirian and Foster:

Both of these EPMG Physicians trained at Children's Hospital and now work here taking care of the Valley's children. They instruct medical students and residents, as well as give lectures to the Medical Staff as a whole. Together as Director and Associate Director they have organized a new education lecture curriculum for the medical community, hospital staff and Residency Program. Recently they prepared for the Residency Program for Accreditation Review and using the available resources were granted full academic accreditation again.

Robert Kezirian, MD (left) and Steven Foster, DO

Stroke remains the No. 3 cause of death in the United States and a leading cause of serious, long term disability.

In November 2003, The Joint Commission, in collaboration with the American Heart Association (AHA)/American Stroke Association (ASA) set out to develop performance measures for DSC Certification for Primary Stroke Centers. This advanced-level certification, unlike basic certification, outlines additional clinically-specific requirements and expectations based on the Brain Attack Coalition’s Recommendations.

J.D. McCourt, MD ED Medical Director University Medical Center University Medical Center of Southern NV	In December of 2007, University Medical Center of Southern Nevada made the decision to seek primary stroke center designation. A steering committee was established & chaired by the Director of the Adult Emergency Department Dr. J.D. McCourt. The emergency department developed an activation response for potential stoke patients presenting to the ED termed "Code Grey". In this system, potential stroke victims have an initial assessment, CT scan, blood test results and determination for thrombolytics made within the first hour. Standardized admit orders for all patients being admitted for stroke or TIA are in place, assuring a more consistent care plan and decreasing morbidity and mortality.
Primary stroke center designation has been sought with The Joint Commission, with plans to become a comprehensive stroke center utilizing the expertise of an interventional radiologist as soon as possible.
Euthym Kontaxis, MD ED Medical Director Eisenhower Medical Center	Eisenhower Medical Center in Southern California has also made the commitment to resources in order to become a primary stroke center. Under the direction of Dr Euthym Kontaxis, Director of the ED, this facility awaits their Joint Commission review April 7th, 2009. Eisenhower’s door to CT time is currently less than 30 minutes, an extraordinary accomplishment. Eisenhower Medical Center also already serves as a stroke center for the Coachella Valley in Southern California, and has a 24-hour Interventional Radiology and Stroke Neurologist call panel in place.

EPMG recognizes the hard work and dedication of Doctors McCourt and Kontaxis and their entire ED staff of physicians, nurses, techs and ancillary service to create this distinguished designation .

METHODIST HOSPITAL OPENS EXPANDED ED!

Sacramento Business Journal—February 26, 2009
by Kathy Robertson, Staff Writer

Methodist Hospital significantly boosted its capacity to treat emergency patients in south Sacramento when a $38.7 million expanded emergency room opened February 27th. Anticipated for more than a decade and under construction for two years, the expansion almost doubles the beds, from 15 to 29, and offers enough space to treat critical patients in every room. With 21,876 square feet of space, the new department is nearly three times the size of the old one. The new facility has the capacity to treat 75,000 patients a year, significantly more than the 44,000 treated now and roughly 35,000 treated five years ago.

“This is a big day for us,” said Dr. Joshua Rubin, Western Region President for Emergency Medicine Physicians, the company that manages services to the emergency room doctors who work at the hospital. “It probably was the smallest emergency department for the volume of patients seen in the country.” Other changes include three critical resuscitation rooms and a decontamination room. A remodeling of the existing emergency department into a new patient waiting room, registration and other support services will be completed in a few months. Gone are the cubicle curtains in the old ER. The new one has only private rooms with walls. An electronic medical record system will go live March 3 and physicians have a glass-enclosed work room in the center of the department so they can work quietly, but see what’s going on.

Robert Kozel, MD
ED Medical Director
Methodist Hospital

MARSHALL MEDICAL CENTER—HEALTHGRADES RECOGNIZED

In January, Health Grades released the names of hospitals in the "Top 5% for Clinical Excellence" for 2009. This year Marshall Medical Center is the only hospital in the Central Valley or Sierra Nevada's from Mexico to Oregon to be recognized in the top 5% for Clinical Excellence by Health Grades. All the hard work of the Medical Staff and employees truly have created something special at Marshall! This year’s study shows that the top 5% of hospitals such as Marshall average a 27% lower mortality rate than the average hospital, for the same type patients. Nationally, fewer and fewer hospitals receive this award each year and most all are much larger hospitals. Marshall has achieved these outstanding results for the past three years, based on the last six years actual results for their patients. The hundreds of community members still with Marshall remain due to the clinical quality. This is what Marshall Medical Staff and employees are all about.
John Tucker, MD ED Medical Director Marshall Medical Center	Michael Dorso, MD ED Quality Director Marshall Medical Center

CONGRATULATIONS 2008 EPMG/EMP SCHOLARS

Your tremendous person growth has been evident by your unwavering attention to site and company issues.

Participation in the Scholars Program has obviously renewed your resolve to strengthen and improve your personal contributions to EMP and to EPMG. We thank you for your commitment to our collective future!

Back row, from left: John Skratt (EPMG), Dale Curtis (EPMG), John Janikas (EMP), Matthew Stupple (EMP), Kevin Corrigan (EMP), Lane Smith (EMP)
Front row, from left: Heather Godale (EMP), Badrith Kulkarni (EPMG), Steven Stephanides (EPMG), David Lancaster (EMP)

WELCOME 2009 EPMG SCHOLARS

The EMP/EPMG Scholars Program is a year-long intensive leadership, self-assessment and mentoring program which helps prepare an individual to serve as a medical director. Scholars meet with experts in the field including EMP, EPMG, MBFS Management, and national experts, and learn the trade of ED management through monthly seminars and national programs. Those who may be interested in the 2010 program may already apply for information by contacting Jennifer Maznio at jmaznio@emp.com. You also may contact our current or past Scholars for the inside scoop!
Steven Schorer, MD 2009 Scholar Director, Physician Services, EMP, WR Mercy Gen ED Physician	Juliet La Mers, MD 2009 Scholar Marshall ED Physician

Mercy San Juan Recognized for Patient Satisfication

Mercy San Juan ED Physicians and staff were recently recognized by Brian Ivie, CEO, for their outstanding improvement and success in Patient Satisfaction. The ED ranked highest overall for all hospital departments, particularly in the areas of likely to "return without hesitation" and to "recommend without hesitation." Their achievement was recognized at the Medical Executive Committee meeting of the hospital in January. Jerry Oliaro, DO, Medical Director for MSJ ED, attributes the success in patient satisfaction with sheer hard work by his physicians, and commented on two newer programs which correlated to their improved scores: Development of an aftercare call back system, which at MSJ is conducted by all Emergency physicians for selected high-risk cases, and, Placement of an RN in the lobby, which appeared to immensely affect patients’ and families’ perception of their treatment at the hospital. EPMG congratulates our emergency physicians and their staff at MSJMC for their solution-driven accomplishments in Patient Satisfaction.

Jerry Oliaro, DO, FACEP EPMG ED Medical Director MSJMC

Mercy San Juan Shines As Quality Leader

Mercy San Juan Medical Center came out a clear quality leader at the CHW Clinical Innovations Symposium held in October in Henderson, Nevada. MSJMC won numerous awards at the annual quality meeting. The sepsis initiative at MSJMC resulted in a 41% reduction in mortality in the past year. MSJMC won two other awards for the Clinical Innovations Project—one for achieving the greatest cost reduction and the second for the best overall performance across CHW. MSJMC was also recognized for being named one of Thomson’s 100 Top Hospitals from top to bottom: Jack Wood, DO, FACEP, EPMG “Ex-Officio” Board Member & President-Elect MSJ Medical Staff Jerry Oliaro, DO, FACEP, EPMG ED Medical Director, MSJMC Dale Curtis, MD, EPMG ED Quality Director, MSJMC

EPMG EDITORIAL PHYSICIANS—AMBASSADORS TO THE COMMUNITY Submitted by Robert Kezirian, MD, FAAP Clinical Department Chair of Emergency Department Children’s Hospital Central California

We are all ambassadors—wherever we go, whatever we do.

A role we did not foresee in training by most of us is engendering goodwill simply through our daily interactions with others. The truth is, we do not live in a vacuum. All of us represent our profession in an official capacity during the best and worst of times, steeped in the ethos of community service.

Everything about us—who we are, where we live and how we practice our craft—is inextricably linked to our patients’ needs, their health, our successes and our sense of duty and self fulfillment.

In today’s world, career and diplomatic successes belong to the committed, to those who work from the heart, who invest themselves passionately in their jobs. Effective people benefit by giving to others. They add value to people’s lives. They fill needs. They solve problems. They help people. They are on the move making a difference and cherishing the fact that the noblest of professions is service to mankind.

Emergency medicine is the epitome of lofty ideals, solid principles and consistent dedication. It does not leave to the poor and disadvantaged only crumbs from the feast. Rather at all times we treat the less fortunate as guests. To demand less of ourselves would be to evade our purpose and proper responsibility.

For all our present travail—the deficits, the stagnant economy, the budget cuts, the homeless, uninsured and unemployed—I believe we have enough wisdom and bravery to bring opportunity and hope to those who have neither.

We can and will refuse to settle for survival and certainly not just survival of the fittest. It is essential to our moral success.

We are the family of medicine feeling patient’s pain, one another’s challenges, sharing one another’s blessings, reasonably, equitably, honestly, fairly, without respect to race or wallet. It is a fierce test of our resolve.

With long days and night call, on duty through weekends and holidays, we are cheered into making the most of the season by the knowledge—caring makes a difference.

The moral test of a society, according to Hubert Humphrey is how it treats “those who are in the dawn of life—the children; those who are in the twilight of life—the elderly; and those who are in the shadow of life—the sick, the needy and the handicapped.”

Thanks to you, emergency physicians are acing the test.

As we begin a new year, may we all resolve to remain gracious and effective ambassadors of good will and good health.

Dr. Kezirian holding an attentive patient

MICHAEL EPTER, DO, FAAEM, RECEIVES PRESTIGIOUS HONOR

Dr. Michael Epter, EPMG physician and the Emergency Medicine Residency Director for the University of Nevada School of Medicine was recently selected to be an oral board examiner for the American Board of Emergency Medicine (ABEM).

EPMG's only other current examiner is Dr. Jack Wood, President Elect at Mercy San Juan Medical Center in Sacramento and Chairman of EPMG's Medical Advisory Board. Formerly, Dr. John Tucker, Medical Director at Marshall Medical Center, served in this capacity as well.

This is a prestigious honor that very few academic emergency physicians achieve.

Congratulations, Dr. Epter!

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