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SNI Forward Newsletter August 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).

With many people across the country taking summer vacations for the first time in years and with the fresh start of a new school year without as many precautions in place, it feels like we are entering a different phase of the pandemic. At the same time, the contagiousness of emerging variants and the latest surges continue to take a toll on hospital operations, specifically staffing disruptions. These disruptions are on top of existing staff shortages and burnout, which have been driven by the relentless toll of the pandemic on our workforce over the past few years.

To help systems strengthen their approaches to workforce wellbeing, SNI launched a new program in August. Public health care systems leaders will have the opportunity to meet monthly over the next year to learn from state and national experts and share approaches and problem-solve with each other. The program includes a webinar series, an in-person meeting on the Wednesday before CAPH/SNI’s annual conference in December, and optional coaching support from experts in various facets of workforce wellbeing. Stay tuned for more information on this new work.

Below we highlight progress in several other SNI priority areas, including efforts to support members as they better integrate virtual health into daily clinical practice and address structural racism in their organizations.

In the coming months, SNI will also continue its core program support and offer a series of events and workshops to help guide systems as they reevaluate and redesign ambulatory care staffing models, operations, and care delivery in the wake of COVID-19. And, we’re busy planning for the CAPH/SNI Annual Conference, the first in-person conference since 2019. We hope to see you there!

Giovanna Giuliani
Executive Director
California Health Care Safety Net Institute

Community of Practice Brings Members Together to Advance Racial Equity

Left to right, from UC San Diego Health: Ridwaan Mohamed, Surgical Specialties Intern, Matthew Jirsa, Administrative Fellow, and Shivon Carreño, Director of Operations, Neurology

SNI, in partnership with the National Equity Project (NEP), held its first in-person convening in over two years in July for the Racial Equity Community of Practice (CoP). Over 50 leaders from 12 public health care systems gathered in Oakland to share strategies on how to advance racial equity in their organizations and engage in peer learning. Attendees learned how to apply NEP’s “liberatory design methodology,” an approach that interrupts inequities by increasing opportunities for those most impacted by oppression, shifting power dynamics in relationships, and increasing agency for those involved in the work. A panel of leaders from Alameda Health System, San Mateo Medical Center, and UCLA Health shared the evolution of their systems’ equity structures and described their systems’ high-level strategic priorities. “We’re talking about undoing 400 years of scientific medicine’s history of validating racism, and that’s our responsibility in this room, and that’s why it takes so much,” said Mikel Whittier, director of health equity, diversity and inclusion, UCLA Health.

Participants also received practical advice for building equity structures and action plans in their own organizations, including how to integrate community voices early in the process and develop a shared language on equity. Most importantly, CoP’s peer-to-peer sharing allows participants to “understand the journeys, the pains, and the successes that other systems have had in their equity work, and what they would do differently,” said Giovanna Giuliani, executive director, SNI.

SNI Supports Members’ Efforts to Expand Virtual Health

As public health care systems reassess their ambulatory care strategies to better integrate telehealth, SNI continues to support members through programming that brings systems together virtually to share strategies, lessons learned, and resources. Recently, Zuckerberg San Francisco General Hospital presented on their Telehealth Ambassador program, which leverages a group of volunteers to help patients overcome digital literacy barriers. Volunteers call patients who are hesitant to use virtual care or experiencing technical barriers and help them get connected to and familiar with virtual care platforms. The Los Angeles Department of Health Care Services also shared their experiences implementing the Health Tech Navigator program. Modeled after the Community Health Worker approach, tech navigators are members of the community who work closely with patients and help support portal enrollment, increase portal use, and bridge longstanding gaps in health care accessibility to improve patient engagement. Later this month, San Mateo Medical Center and UC Davis Health will discuss approaches to standardize virtual care operations, clinical workflows, and provider engagement strategies.

Six Reflections on the Pandemic from California’s Public Health Care Systems

Earlier this summer, we released the last blog in our series on California’s public health care systems’ pandemic response. We highlight how some of the oldest hospitals in the state turned into hotbeds of innovation and how mission-driven teams of health care workers creatively overcame some of the most daunting challenges to provide more equitable care, and what they learned along the way. Thank you to the dozens of people who participated in this California Health Care Foundation-sponsored blog series. We are grateful and humbled to have had the opportunity to try and capture how our systems have comprehensively and compassionately cared for patients at every unpredictable turn.