Welcome
Happy new year and welcome to the SNI Forward! You may have noticed that we have a new look. Like many organizations over these past few years, we have reflected deeply on our organizational priorities and commitment to our mission. As part of our evolution and growth, we felt it was time to update our brand and our website. Our new logo reflects our bold and bright commitment to our work, as well as the synergy and partnership between SNI and our partner organization, the California Association of Public Hospitals and Health Systems.
With the start of the new year, we’ve passed the halfway mark for SNI’s Workforce Wellbeing program. Below we describe how this work has evolved and what’s coming next. We also feature the winners of our 2022 Quality Leaders Awards (QLA), announced last month at our annual conference. The QLAs represent just a glimpse of the inspiring work happening on the ground across all public health care systems as they continue to chart a path forward in this COVID-endemic world. We are honored to recognize these systems for their hard work.
As we look ahead, SNI will continue to support members’ efforts to advance racial equity through our Community of Practice with in-person workshops and expert coaching focused on leadership development and creating the conditions for organizational change. We also continue to support ambulatory care transformation, helping systems evolve in a COVID-endemic environment, including a focus on patient outreach and engagement to improve population health.
Giovanna Giuliani
Executive Director
California Health Care Safety Net Institute
Workforce Wellbeing
Several years since the beginning of the pandemic,
public health care systems are suffering from an unprecedented staffing crisis with high rates of turnover and a widespread feeling of burnout. Launched in August 2022, SNI’s workforce wellbeing program is helping systems recover and rebuild. The program has provided members with a wealth of evidence-based resources to help improve provider and staff wellbeing, starting with a three-part webinar series featuring national experts who summarized the current state of workforce burnout, evidence-based solutions, and effective measurement strategies (see webinar recaps for key takeaways).
Building on this foundation, phase two of the program focuses on leadership and system approaches to improve wellbeing. This phase began with an in-person workshop during CAPH/SNI’s annual conference. A panel of Chief Wellness Officers shared their experiences gaining leadership buy-in and securing resources to build a systemwide-approach to wellbeing. In the coming months, participants will hear from national experts, as well as peer health systems, about leadership practices that foster a culture of psychological safety and trust, as well as ways to align wellbeing with Diversity, Equity, and Inclusion initiatives. Additionally, several systems will work with an expert coach to advance their organization’s efforts. As one member shared following the workshop: “It’s really useful and motivating to see the range of systems that are each at a different stage in their journey.”
Photo: Public health care system participants at the Workforce Wellbeing meeting at CAPH/SNI’s annual conference in December.
2022 Quality Leaders Awards Winners
In December, we were pleased to announce the 2022 Quality Leaders Awards winners at our CAPH/SNI Annual Conference, thanks to funding from Kaiser Permanente. The QLAs highlight innovative approaches to advance equitable high-quality care in California’s public health care systems. Learn more about our 2022 winners below.
Top Honor – Alameda Health System
BElovedBIRTH Black Centering
Alameda Health System’s BElovedBIRTH Black Centering is an innovative solution to the Black maternal and infant health crisis, developed by and for the Black community. BElovedBIRTH is a group perinatal care program combining multiple evidenced-based strategies into one comprehensive “Gold Package of Black Love,” designed to honor and celebrate Back birthing people while addressing racism-based disparities. The program utilizes four strategies that include midwifery led group visits, racial concordance – care provided by an all-Black care team, wrap-around support provided by family advocates, and racially and culturally aligned patient education. Since launching in 2020, BElovedBIRTH has achieved significant improvement in birth outcomes.
Equity – University of California San Diego Health
Establishing Same Day Infusion Treatment Protocols for Uncomplicated Sickle Cell Vaso-occlusive CrisesUtilizing a Telemedicine Platform
Individuals with Sickle Cell Disease (SCD) are high utilizers of Emergency Department (ED) services for treatment of uncomplicated vaso-occlusive crises (VOCs), which present as episodes of pain. SCD disproportionately affects African Americans, and individuals with SCD face barriers to care when accessing treatment in the ED, which can lead to significant health care disparities. The lack of outpatient based SCD care often results in many potentially avoidable ED visits and hospital admissions, which is inefficient and frustrating for patients. To address this issue, University of California San Diego Health established a same-day infusion program by leveraging a telemedicine platform and workflows and their outpatient infusion center to triage, assess, and treat patients experiencing VOCs in a timelier and more patient-centered manner, while reducing ED utilization.
Innovation – San Mateo Medical Center
Establishing Partnerships to Meet Food Needs
During the height of the COVID-19 pandemic, San Mateo Medical Center (SMMC) had an increase of patients reporting food insecurity. In addition to organizing on-site pick up and home delivery of food boxes, SMMC launched a strategic initiative to better identify food insecurity needs in their community and connect patients with nutritious food resources. SMMC standardized workflows to screen every patient for food insecurity and developed a QR based technology for referrals in partnership with Second Harvest Food Bank. Other key components include warm hand-offs to social workers for real-time support and new electronic health record templates. The standard work process is now being deployed more broadly to medical assistants, providers, social workers, and registered dieticians across the system.
Population Health – Contra Costa Health Services
Patient Engagement Using Data Insights
To address delays in preventive care that resulted from the COVID-19 pandemic, Contra Costa Health Services (CCHS) established a coordinated outreach strategy utilizing their electronic health record (EHR). In conjunction with making real-time data accessible through the EHR, CCHS leveraged a team of interns to conduct outreach calls that addressed each of the patients’ specific needs. With this approach, they were able to place over five thousand calls a month, resulting in a more effective and efficient outreach process and improvements in the quality of care for a range of chronic disease and preventive screening measures.
Care Redesign – Riverside University Health System
Utilizing Lean Methodology to Improve Access in RUHS Community Health Centers
In 2020, Riverside University Health System’s (RUHS) Community Health Clinics identified an opportunity to improve their daily huddle process. The huddles lacked uniformity and continuity, leading to fewer-than-average patients being seen per hour compared to the national standard. To improve access and set standards across all community health clinics, RUHS embarked on a two-year Lean journey. They optimized daily huddles and huddle boards, redeveloped standard work, implemented standardized rapid improvement events, and delivered Lean coaching and mentoring sessions to front-line and executive team members. RUHS saw immediate improvements in communication between care team members and productivity, which led to significant improvements in access, marked by an additional 56,000 visits and 10,000 unique patients seen annually per year.
Honorable Mention – Santa Clara Valley Medical Center
Women’s Urgent Care to Improve Delivery of Care in the Pandemic
In Santa Clara County and across the country, long wait times in emergency departments were made even worse by COVID-19. Seeing the rising needs and the challenge of providing access to urgent OBGYN care, the Bascom OBGYN Urgent Care clinic at Santa Clara Valley Medical Center was founded to provide women with same-day or walk-in ambulatory care directly by OBGYN specialists. This specialty urgent care model is designed to help women with gynecologic needs who would have otherwise sought care in the emergency department. To date, the clinic has delivered over 5,000 visits, successfully increased access to specialty care and facilitated continuity to follow-up care in the outpatient OBGYN department. The clinic continues to provide urgent services, including ultrasound and procedural services, and has provided a framework to guide efforts for future OBGYN urgent care service inside and outside Santa Clara Valley health care systems.