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December 09, 2016 - “Cefotetan-induced hemolytic anemia and potentially life threatening reactions to transfused blood products”
Speaker: Laurel Yocom, MD, Central Oregon Pathology Consultants, PC

Objectives: Objectives: 1) Present case reports of Cefotetan-induced immune hemolytic anemia, 2) Discuss serious transfusion reactions and educate on recognizing these entities, 3) Define serious transfusion reactions, and 4) inform about a possible false positive antibody screen result related to the new medication for myeloma, Daratumumab.

Handouts: CME_120916_Yocom_HOs_Cefotetaninduced_hemolytic_anemia

December 02, 2016 - "Evidence-based review of tPA"
Speaker: Hormozd Bozorgchami, MD OHSU

Objectives: Objectives: 1) Provide an evidence-based review of tPA, 2) Identify candidates for tPA, 3) Determine the best course of treatment for patients with chronic co-morbidities and tPA, 4) Identify key messages for patients and caregivers contemplating and/or receiving treatment for acute ischemic stroke.

Handouts: CME_120216_HOs_Bozorgchami_Acute_Stroke_Treatment

November 11, 2016 - "Treatment Strategies for Depression"
Speaker: Bruce Spring, MD, Clinical Assistant Professor of Psychiatry Keck School of Medicine of USC

Objectives: Objectives: 1) Name three diagnoses of depressive disorders, if it is within his/her practice profile. 2) Identify factors in antidepressant selection. 3) Discuss the best drug for certain patients based on detailed history, comorbidity, and clinical features. 4) Address the efficiency and side effects of antidepressant therapies. 5) Consider how cultural aspects may affect prevalence, diagnosis, treatment plans, etc. and navigate these issues effectively.

Handouts: CME111116SpringTreatmentStrategiesforDepressonHOsBW

November 04, 2016 - "Disease Prevention: The Important Role of Brief Physician Counseling"
Speaker: Carolyn J Sachs, MD., MPH Professor of Emergency Medicine Dave Geffen School of Medicine at UCLA

Objectives: Objectives: 1) to increase physicians' knowledge of the recommended minimum guidelines for a variety of chronic conditions; 2) to detail the barriers faced by patients in adhering to medication and lifestyle recommendations; and 3) to aid physicians in providing counseling to patients during medical visits.

October 21, 2016 - TRAUMA “Update on Burn care and Resuscitation”
Speaker: Niknam Eshraghi, MD, FACS, Associate Director of the Oregon Burn Center at Legacy Emanuel Medical Center

Objectives: Objectives: 1) Define the magnitude and severity of the injury. 2) Identify and establish priorities of treatment. 3) State the ABCDEF’s of a burn injury during the first hour of care (airway damage, burns to chest wall for breathing problems, circulation management, disability status, exposure and cover, fluid resuscitation). 4) List the three do’s and three don’t of appropriate care of a burn injury. 5) State three criteria for transfer to a burn center and identify appropriate transfer protocols to the Oregon Burn Center.

Handouts: CME_102116_Eshraghi_UpdateonburncareandResuscitation_HOs

October 07, 2016 - “Opioid Tapering and Harm Reduction for the Lost Generation”
Speaker: Paul C. Coelho, MD, Oregon Pain Commission

Objectives: Objectives: 1) Discuss the new CDC Opioid Guidelines, 2) reiterate the opioid overdose deaths nationwide, statewide, and in our region, 3) explain the risk of co-prescribing benzodiazepines and opioids, and 4) appropriately taper a patient on opioids.

Handouts: CME_100716_Alternatives_To_Benzodiazepines, CME_100716_BendHarmReductionTalk2, CME_100716_FearofWithDrawalDrivesContinuedUse, CME_100716_OpioidWithdrawalAttenuationCocktail

September 30, 2016 - “Melanoma in Central Oregon”
Speaker: John Vetto, MD, OHSU Knight Cancer Center, Division of Surgical Oncology

Objectives: Objectives: 1) Describe the symptoms of melanoma, 2) Identify the factors that may contribute to the higher rates of melanoma in Central Oregon compared to the rest of the state, 3) Explain the impact of genetics and family history on incidence of melanoma, 4) Illustrate the effect on the DNA of a person who gets a sunburn, 5) List the formal guidelines for skin cancer screenings, 6) List the three primary ways to protect oneself against melanoma.

Handouts: CME_093016_MelanomaInCO2016HOs

September 23, 2016 - "When Caring Hurts – Helping You Get the Support You Need"
Speaker: Viki V. Kind, M.A. Bioethics Education

Objectives: Objectives: 1) Discuss how professional compassion fatigue may be affecting our interactions. 2) Learn how to say, "No" when people are asking for too much and when to say, "Yes" to taking time for yourself. 3) Demonstrate stress reduction activities. 4) Identify how build a support system for yourself and within your profession.

Handouts: CME_092316_Kind_HO_HowToSayNo2013, CME_092316_Kind_HO_stressExhaustionSymptoms, CME_092316_KindHOs_2016

September 16, 2016 - "Out of Sync Kids: An Update on Sensory Processing Integration Disorder"
Speaker: Elysa Marco, MD, Assistant Professor of Neurology, UCSF*

Objectives: Objectives: 1) Recognize that children affected with SPD have quantifiable differences in brain structure that sets it apart from other neurodevelopmental disorders, 2) Conduct a sensory evaluation to identify symptoms of SPD and differentiate them from other neurological disorders, 3) Develop a “sensory diet,” treatment plan 5) Determine if the child requires an Individualized Education Plan (IEP) to help them succeed in school.

Handouts: CME_091616_Marco_HOs_Marco

September 09, 2016 - "Moving from Acute and Ambulatory Care To Population Health Management"
Speaker: David Tinkelman, MD Medical Director National Jewish Health Initiatives / Disease Management*

Objectives: Objectives: 1) Describe challenges in moving from a fee-for-service model to a value-based, population health-oriented system of care 2) Define population health using examples of social determinants of health, 3) Explain how new care delivery models like patient-centered medical homes and Accountable Care Organizations can facilitate the practice of population-based care 4) List key drivers of changes in physician culture that will promote accountability.

Handouts: CME_090916_Tinkelman

July 29, 2016 - “Improving Outcomes and Patient Satisfaction Using The Perioperative Surgical Home (PSH) Model"
Speaker: Jeff Meuhling, MD, &/or Rick Hanson, MD

Objectives: Objectives: 1) Recall elements and details of the national perioperative surgical home program as described by the ASA, 2) Describe the major criteria for perioperative patient optimization and risk stratification. 3) List the benefits of coordinated care throughout the surgical experience (care continuum), 4) List the options for planning and managing pain throughout the surgical experience, and 5) Identify the benefits of patient activation in the surgical care plan.

Handouts: CME_072916_HansonPSH_GRHOs

July 22, 2016 - “No Grand Rounds Medical Staff Meeting”

July 15, 2016 - "Coccidiodomycosis in the Pacific Northwest- How about Oregon? Clinical, Epidemiological, Diagnostic and Environmental Aspects of Coocidiomycosis"
Speaker: Jon Lutz, M.D., F.A.C.P.Infectious Disease Specialist, St Charles MC; Orion McCotter, Coccidiomycosis Epidemiologist, Centers for Disease Control; Emilio DeBess, DVM, MPH - Public Health Veterinarian, Oregon

Objectives: Objectives: 1) Learn the different clinical presentation of patients affected with coccidiomyciosis 2) Understand the epidemiology of coccidiomycosis in patients in the Pacific Northwest and other parts of the US 3) Discuss diagnostics and proper isolation of the organisms 4) Learn about soil /environmental testing and its significance for patient health.

Handouts: CME_071516_CocciHumans_FINALSlidesCombined

July 08, 2016 - No Grand Rounds

July 01, 2016 - No Grand Rounds - Independence Day Weekend

June 24, 2016 - “Prostates and Broccoli: Sulforaphane Supplementation and Prostate Cancer Prevention”
Speaker: Jackie Shannon, PhD Associate Professor, OHSU- School of Public Health

Objectives: Objectives: 1) Describe the epigenetic mechanism whereby sulforaphane may prevent or slow prostate carcinogenesis, 2) Discuss difficulties experienced in recruitment to a prostate cancer prevention trial, and 3) Describe changes in blood, urine and tissue identified following supplementation with sulforaphane.

Handouts: CME_062416_Shannon_ProstatesBroccoli_HOs

June 17, 2016 - "Safety of Dietary Supplements"
Speaker: Adriane Fugh-Berman, M.D. Associate Professor of Physiology and Biophysics Georgetown University School of Medicine

Objectives: Objectives: 1) Participants will become familiar with the quantity and quality of data on the efficacy and safety of several common herbs (including cannabis) and dietary supplements 2)Participants will be able to differentiate among common herbs that should be avoided entirely, herbs that should only be used with caution, and benign herbs. 3) Participants will be able to describe several known interactions between prescription drugs, cannabis, and dietary supplements . 4) Participants will become familiar with the data on St. John’s-wort interactions with drugs and will learn how to manage patients who are combining the two.

Handouts: CME_061716_FughBerman_Herbs_Supplements_HOs

June 10, 2016 - "Clostridium difficile Infection. Can We Tame the Beast?"
Speaker: Johan S. Bakken, MD, PhD, FACE, FIDSA, Clinical Associate Professor of Medicine, University of Minnesota, Duluth, Minnesota

Objectives: Objectives: 1) Summarize data on emerging agents for the treatment of CDI, 2) Assess how emerging agents may address unmet needs in the treatment of CDI, 3) Identify the effect of gastric acid suppressive therapy on the incidence of Clostridium difficile infection, and 4) Describe the effect of the use of proton pump inhibitors on the risk for recurrent Clostridium difficile infection.

Handouts: CME_061016_CDI_BendHOs

June 03, 2016 - “Active Shooter”
Speaker: Mark W. Mooring, MPA, CPP, CHPA

Objectives: Objectives: 1) Identify safety and survival strategies specific for their institution during an active shooting event 2) Assess both effective and non-effective responses to an active shooting event 3) Initiate the development policies, procedures and training for such events.

Handouts: CME_060316_MarkMooring_HOs

May 27, 2016 - No Grand Rounds - Memorial Day Weekend

May 20, 2016 - “Josie’s Story: Family-Centered Approaches to Patient Safety”
Speaker: Sorrel King, Patient-safety Advocate and Cofounder of the Josie King Foundation

Objectives: Objectives: 1) Recognize characteristics of an effective patent-family-health care provider relationship. 2) Describe methods that can be used to facilitate effective communication between patients and providers. 3) Discuss an adverse event that could be prevented by effective communication between patients, families and providers.

Handouts: CME_052016_SorrelKing_HOs

May 13, 2016 - “Parkinson's Disease: Improving Quality of Life by Tackling Non-Motor Symptoms”
Speaker: Richard Rosenbaum, MD, author of the book “Understanding Parkinson’s Disease. A Personal and Professional View”

Objectives: Objectives: 1) Identify and assess nonmotor symptoms in patients with Parkinson's disease, 2) Discuss the impact of these symptoms on patients with PD, and 3) Offer treatment strategies to improve nonmotor symptoms

Handouts: CME_051316_Rosenbaum

May 06, 2016 - "The Nuts and Bolts of MOC, Why Do We Need It, Why I Should Care?"
Speaker: David Price, MD, FAAFP, FACEHP, Senior Vice President, American Board of Medical Specialties Research and Education Foundation; Executive Director, Multi-Specialty Portfolio Approval Program Organization

Objectives: Objectives: 1) Describe what Maintenance of Certification is, 2) Describe the pros and cons ofen rolling in your board’s MOC program, 3) Describe the pros and cons of opting out of participation,4) Identify evidence-based studies that prompted the development of MOC, 3) Identify the benefits for the physician learner, 4) Identify the impact on patient outcomes. **Please note: videos and handouts are unavailable at the speaker's discretion.**

April 29, 2016 - "Stabilizing Chronic Pain Patients With Medication-Assisted Treatment (MAT)"
Speaker: John McIlveen, PhD, LMHC from OHA and Jessica LeBlanc, MD, MPH

Objectives: Objectives: 1) Discuss background and evidence of Medication Assisted Treatment (MAT),2) Review the data and up-to-date research on suboxone and buprenorphine, and 3) Apply the MAT program in a primary care setting after a patient has been stabilized

Handouts: CME_042916_LeBlanc_MAT, CME_042916_LeBlanc_MAT_HOs

April 22, 2016 - "PrEP: a Prescription to Stem the HIV Epidemic"
Speaker: Dr. Paul DenOuden Faculty, Oregon AIDS Education and Training Center

Objectives: Objectives: 1) Provide an overview of the latest research and clinical guidelines on PrEP, an intervention to prevent HIV infection, 2) Discuss important considerations when screening and counseling PrEP patients,3) Describe available local resources to help with drug access and adherence

Handouts: CME_04222016DenOuden_PrEP

April 15, 2016 - "Update in Outpatient Medicine"
Speaker: Robert A Gluckman, MD, FACP, Internal Medicine Specialist; Chief Medical Officer, Providence Health Plans

Objectives: Objectives: 1) Using results from recent studies, discuss current evidence relevant to outpatient internal medicine. Topic areas include breast cancer screening guidelines and the SPRINT Trial (more aggressive blood pressure targets). Final content will depend upon most recent publications.

Handouts: CME_04152016Gluckman_UpdateOutpatientMedicine

April 08, 2016 - "The Great Masquerader: Raising Awareness of the Rapidly Rising Incidence in Syphilis and other Bacterial STIs"
Speaker: Sean Schafer, MD, Medical Epidemiologist, Oregon Public Health Division, HIV/STD/TB Program; Richard Fawcett, MD, Health Officer, Deschutes County Health

Objectives: Objectives: 1) Identify and test individuals at risk for syphilis and gonorrhea. 2) Discuss the multiple clinical presentations of syphilis and gonorrhea. 3) Review laboratory test algorithms for a diagnosis of syphilis and discuss appropriate treatment regimens.

Handouts: CME_04082016_Schafer_colorhandouts_slides155, CME_04082016Fawcett_TheGreatMasquerader

April 01, 2016 - TRAUMA CME “Tranexamic Acid: From Trauma to Total Joints to Tooth Aches”
Speaker: Thomas DeLoughery, MD, FACP, Professor of Medicine, Pathology, and Pediatrics, Divisions of Hematology/Medical Oncology and Laboratory Medicine, OHSU

Objectives: Objectives: 1) Review the mechanism of action for TXA, 2) Calculate appropriate doses for TXA, and 3) Control hemorrhage across a wide range of clinical settings using TXA.

Handouts: CME_04012016_DeLougheryTXA

March 18, 2016 - "Diagnosing with Real-Time PCR"
Speaker: Ellen Jo Baron, Ph.D., D (ABMM), Executive Director of Technical Support, Cepheid; Professor Emerita of Pathology, Stanford University School of Medicine

Objectives: Objectives: 1) Review PCR technology and its advances in recent years, 2) Discuss current test options, and 3) Identify when Real-Time PCR may be appropriately used for diagnosis.

Handouts: CME_03182016_BaronDiagnosingRealTimePCR

March 11, 2016 - "Host-Gut Microbiota Metabolic Interactions"
Speaker: Michelle M.Pietzak, MD,LAC+USC Healthcare Network Dept. of Pediatrics Los Angeles, CA

Objectives: Objectives: 1) Understand how these trillions of bacteria orchestrate your physiology; including thoughts, food cravings and level of body fat, 2) Help patients tune up their metabolism, balance blood sugar and reduce inflammation all by increasing the health of gut microbiome.

Handouts: CME_03112016HostGutMicrobiotaMetabolicInteractions

March 04, 2016 - No Grand Rounds

February 26, 2016 - "How Doctors Can Help Patients Interpret ‘Spit Kit’ (Genetic testing) Test Results"
Speaker: Katherine Wasson, PhD, MPH, Assistant Professor Neiswanger Institute for Bioethics Loyola University Chicago

Objectives: Objectives: 1) Learn about the variety of DTC genetic tests available in the U.S. 2) Discuss why consumers choose to pursue DTC genetic testing, 3) Identify concerns regarding DTC genetic testing, and the differences between DTC and Clinical Genetic Testing, 5) Discuss what to do When a patient brings you their test results.

Handouts: CME_02262016_WassonOR_DTCGT_1

February 19, 2016 - "HPV: You are the Key to Cancer Prevention"
Speaker: Barbara Pahud MD MPH, Assistant Professor of Pediatrics, Associate Director, Children's Mercy Hospital VTEU

Objectives: Objectives: 1) Review the pathophysiology of HPV infections in men and women, 2) Recognize the burden of HPV disease in the US, 3) Discuss HPV vaccine as a primary cancer prevention tool, and its mechanisms of action, and 4) Describe how to make a strong vaccine recommendation to parents.

Handouts: CME_021916_Pahud_Key_to_cancer_prevention

February 12, 2016 - "Enhanced Recovery After Surgery (ERAS)"
Speaker: Tim Beard, MD, Bend Memorial Clinic

Objectives: Objectives: 1) Define Enhanced Recovery After Surgery and discuss the ERAS Care model, 2) Describe the ERAS Protocol, 3) Identify the 20 care elements that have been shown to influence care time and postoperative complications. 4) Discuss how best to customize the ERAS Implementation Plan in your healthcare environment, 5) Build well-functioning teams from various units involved in surgical care, and 6) Introduce highly specific changes to current routines to conform to best-practice. 7) Determine how best to integrate the ERAS Interactive Audit System into existing practice flow and EHR systems.

Handouts: CME_02122016_BeardEras

February 05, 2016 - "Responding To Adverse Life Events: Creating Safe Places"
Speaker: Maggie Bennington-Davis, MD, MMM, Chief Medical Officer and Chief Operating Officer, Cascadia, Behavioral Healthcare

Objectives: Objectives: 1) Describe the neurobiological impact of exposure to trauma and violence, particularly in childhood. 2) Analyze the physical and mental health impacts of such exposures. 3) Explore application of this understanding to provider behavior and organizational processes. 4) Gain 4-5 explicit ideas for changing to a trauma informed culture.

Handouts: CME_02052016_NeurobiologyOfKindness

January 29, 2016 - "Slowing the Progression of Chronic Kidney Disease"
Speaker: Golriz Jafari, M.D., Health Sciences Assistant Professor of Medicine, Division of Nephrology and Hypertension, Olive View-UCLA Medical Center, David Geffen School of Medicine at UCLA

Objectives: Objectives: 1) Understand the pathophysiology of Chronic Kidney Disease, 2) Review the importance of testing for GFR, 3) Discuss approaches for working with Stage 3 CKD patients, 4) Review kidney-friendly diet and nutrition strategies, 5) Discuss long-term management plans for Stage 3 and Stage 4 patients.

Handouts: CME_01292016_KidneyDisease

January 22, 2016 - "Reversing the Jenny McCarthy Effect: Promoting and Maintaining Community Immunity"
Speaker: Pia. S. Pannaraj, MD, MPH, Assistant Professor of Pediatrics, Keck School of Medicine of USC, Division of Infectious Diseases, Children's Hospital Los Angeles

Objectives: Objectives: 1) Discuss the pros and cons of childhood vaccinations. 2) Overcome parents’ fear that childhood vaccinations cause autism. 3) Learn how to talk to parents about vaccines and provide them with current information on the benefits.

January 15, 2016 - “Zombies Don’t Lie: Death Investigation and Certificate Tidbits”
Speaker: Jana Van Amburg, MD, Deschutes County Medical Examiner

Objectives: Objectives: 1) Discuss when Oregon state requires the medical examiner to complete a death certificate.2) Using case examples, discuss the death investigation process. 3) Differentiate between accident versus natural death determination.

Handouts: CME_01152016_ZombiesDontLie

January 08, 2016 - “Motivating Patients to Take Care of Their Chronic Illness”
Speaker: Bruce G. Bender, Ph.D; Co-Director, Center for Health Promotion National Jewish Health Denver, Colorado

Objectives: Objectives: 1) Identify factors that influence medication adherence, 2) Describe the adverse consequences of medication nonadherence, 3) Summarize the effectiveness of interventions on medication adherence and on health outcomes. 4) Apply this information to interventions on medication adherence with your patients. 5) Provide accurate and appropriate counsel as part of the treatment team. 6) Provide appropriate care and counsel for patients and their families.

Handouts: CME_010816MotivatingPatients_Bender_HOs