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SNI Forward Newsletter May 2022


Welcome to the SNI Forward, our quarterly snapshot of the transformation progress at California’s public health care systems and the work of the California Health Care Safety Net Institute (SNI).

SNI, like many of you, is trying to get a foothold in these ever-changing times of COVID. As health care shifts from a state of crisis to a more proactive approach, SNI is evolving its programming to help members inform the development of their ongoing COVID response structures, as well as new care delivery models that have emerged as part of their COVID recovery efforts.

In this newsletter, we feature several key examples of this work including an initiative to address systemic racism and strategies to integrate virtual care into routine clinical care. We also spotlight Kern Medical’s efforts to address the workforce shortage in light of COVID-19 and UCI Health’s remote patient monitoring program initially launched for COVID-19 patients.

Another area of focus that we are developing is workforce wellbeing. Many providers have experienced (and continue to experience) trauma, stress, and exhaustion from serving on the frontlines of the pandemic. This new effort will be shaped and informed by focus groups that SNI is currently conducting with members. Stay tuned for more information on this program.

In the coming months, SNI will remain focused on supporting members through COVID recovery efforts and the ongoing implementation of CalAIM and the Quality Incentive Pool (QIP), which drives clinical and delivery system transformation, building upon the success of PRIME (read about UCLA’s recent evaluation findings here).

Giovanna Giuliani
Executive Director
California Health Care Safety Net Institute

Racial Equity Community of Practice

Earlier this year, SNI launched its Racial Equity Community of Practice, an 18-month learning collaborative that supports public health care systems’ ability to advance racial equity in their organizations. SNI selected the National Equity Project, an Oakland-based leadership and systems change organization with deep expertise in advancing equity, as its partner. We’re excited to share that our cohort includes nearly 70 leaders across 12 public health care systems.

The program includes two key phases: level-setting and learning and action. In January, SNI hosted a successful virtual kick-off meeting to launch the level-setting phase. In this phase, team members built the critical foundation of a shared understanding of the structures of historical racism and the language and courage to openly discuss racism and its impacts. They also developed a sense of connection, openness, and transparency with their peers, all of which strengthens these leaders and organizations as they prepare for change.

As we enter the learning and action phase this month, teams will equip themselves with a set of tools to implement racial equity efforts in their systems. Over the next 14 months, teams will participate in “liberatory design cycles” to design and test solutions that interrupt systems of inequity and improve racial equity. They will meet in-person and online to share successes, failures, and lessons learned with one another to build on their collective wisdom and move towards equity.

We are deepening our understanding of organizational change and confronting racism through this process and will share updates along the way. Learn more about the Racial Equity Community of Practice.

Virtual Care

Building on lessons learned during the pandemic, public health care systems are incorporating virtual care as part of their long-term organizational strategy. To guide this work, SNI conducted an assessment to help members evaluate and prioritize their virtual care efforts. The results revealed four key priority areas: virtual care governance, operations, patient engagement, and health equity.

In response, SNI developed a webinar series, where public health care system participants learned how to select, monitor, and leverage key performance indicators (KPIs). UC San Diego Health also shared their strategy for telehealth decision making, including resource allocation practices. Other webinars included an overview of hybrid virtual and in-person care models with Contra Costa Health Services and tech navigator solutions to help patients with digital literacy barriers connect to video visits.

Next up, SNI will launch a webinar series to address the digital divide through topics like digital literacy, language access, and staff engagement.

Member Spotlight

Pressures from the Pandemic at Kern Medical

A clinical team at Kern Medical tends to a patient. Photo credit: CAPH/Kern Medical.

“There are days when it’s so much easier to just worry about myself,” said Alicia Gaeta, a nurse at Central Valley’s Kern Medical. “And then I see how hard everyone’s working, and that encourages me to keep going.”

As a continuous cascade of patients requires care for everything from car accidents to clinical depression, Kern Medical’s trauma center and inpatient psychiatric unit – the only such specialized facilities in the area – are experiencing a record-breaking volume of cases.

Meanwhile, the number of medical assistants, nurses, and other health care professionals at Kern Medical has thinned, reflecting national trends of medical workers leaving hospitals in large numbers during the pandemic. In our latest blog, learn about how Kern Medical continues to care for patients, support its indomitable workforce, and attract new health care professionals. And read about the hospital system’s opportunistic strategy for recruiting the future generation of Kern Medical staff.

UCI Health’s Innovative Remote Patient Monitoring Program

Susanna Rustad, UCI Health’s chief procurement officer and executive director of virtual care, and Khurram Mir, senior program manager, seen on a computer screen from a remote location. Photo credit: Kyusung Gong.

“The demand for acute care is high, and our hospital has been at capacity and constrained for years,” said Susanna Rustad, chief procurement officer and executive director of virtual care at the University of California Irvine Health (UCI Health).

To help decompress its in-patient units, reduce the lengths of hospital stay, and deliver a better patient experience, UCI Health started caring for 70 COVID-19 patients in January 2021 with the launch of its innovative remote patient monitoring program.

In our interview with Rustad and Khurram Mir, senior program manager at UCI Health, you will read about how this expanding program works, how patients have responded, and practical advice on what hospital systems should consider when embarking on remote patient monitoring. You’ll also learn about UCI Health’s plans for a full-fledged hospital-at-home program.