SNI Bulletin SNI
June 24, 2013

In this SNI Bulletin:
CAPH Member Selected to Join IHI as Kaiser Permanente (KP) Safety Net Fellow
The Sepsis and CLABSI Collaborative Hosts Two Successful Vascular Access Courses
Embedding Lean Year 2 Begins!
Community of Practice for Palliative Care Interpreters
Delivery System Reform Incentive Program Aggregate Report


CAPH Member Selected to Join IHI as Kaiser Permanente (KP) Safety Net Fellow

Gilbert Salinas, MPAc, Director of Patient and Community Relations at Rancho Los Amigos National Rehabilitation Center, will begin a one-year fellowship in July 2013 as Kaiser Permanente’s second Safety Net Fellow at the Institute for Healthcare Improvement (IHI). This marks the second year in a row that a CAPH member has received this honor. Through guidance from Anna Roth, (current SNI Board Chair and 2007/2008 IHI Fellow), Dr. Winston Wong (Medical Director of Community Benefits at Kaiser Permanente and former SNI Board member), and Dr. Don Goldmann (IHI Senior Vice President), Kaiser Permanente developed this safety net sponsorship to provide an opportunity for emerging safety net leaders to participate in IHI’s acclaimed Fellowship Program.

Contact: Nermeen Iskander

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The Sepsis and CLABSI Collaborative Hosts Two Successful Vascular Access Courses

Through the Sepsis and CLABSI Collaborative, generously funded by the Blue Shield of California Foundation, SNI offered two vascular access courses in Northern and Southern California on “Best Practices in Managing Central Venous Access Devices. “The courses, held in May and taught by expert Nadine Nakazawa, RN, BS, OCN, VA-BC, provided participants with case studies and strategies to prevent central line infections, including proper maintenance care and safe removal of peripherally inserted central catheters and central venous catheters. Participating hospital systems sent teams of nurses, managers, physicians and infection preventionists, with a combined attendance of 159 participants in Oakland and Burbank. After a full day of learning, attendees left the session feeling empowered with a deeper understanding of the importance of prevention. Attendees ranked the course highly and expressed that the content was relevant and applicable to their work. The sessions served as an educational opportunity for members, with one participant stating, “The course exceeded my expectations! The content was informative, useful and added a depth of knowledge that I was missing. I think this course should be offered to all RNs on our unit. I believe in zero CLABSIs and I can make a difference after attending this lecture!”

The 2-year Sepsis/CLABSI Collaborative will conclude next month with a final convening on July 31st at the Gordon and Betty Moore Foundation. Participating hospitals will share their data and results, best practices, and lessons learned throughout the Collaborative with leadership and colleagues. Registration and a detailed agenda will be sent to Collaborative members.

Contact: Rosemary Phu

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Embedding Lean Year 2 Begins!

The second year of the Embedding Lean in Public Hospitals initiative kicked off with an in-person convening in Oakland on June 11th. There are currently eight California public hospital systems engaged in lean transformational work and seven of these systems were represented at this day-long event. Five (Alameda Health System, Contra Costa Regional Medical Center, San Mateo Medical Center, San Francisco General Hospital, and Harbor-UCLA Medical Center) have received matching grants from the California HealthCare Foundation based on their prior experience with Lean management and their demonstrated organizational commitment and readiness to expand the use of Lean within their systems.

The day-long convening was highly interactive and began with presentations by each hospital system. There was great energy and discussion around visibility walls—part of the Lean visual management system—which provide a quick overview of the active work through metrics that are clearly linked to the organization’s strategic plan.  Another highlight of the day was a hands-on session where attendees participated in a series of exercises to calculate the ROI, or ROK (return on Kaizen), under the tutelage of Dr. Thomas Jackson from the Rona Consulting Group. Evaluations showed that participants rated the day highly and truly valued the opportunity to share and learn from their sister hospitals.

During this upcoming year of the Embedding Lean grant, across the five grantee systems, essentially all areas of the public hospital delivery system will be targeted. Planned value streams include: primary care and specialty clinics, operating rooms, emergency department, radiology, patient safety, psychiatry, pharmacy, medical-surgical units, inpatient discharge, and transitions.

Contact: Denise Gonzalez

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Community of Practice for Palliative Care Interpreters

Because language barriers can jeopardize the quality and safety of patient care, healthcare interpreters are a vital link between patients and providers. With health reform right around the corner, it is expected that the need for language access services will further increase since many of the newly insured are predicted to be limited English proficient.

As part of the multi-year CHCF-funded Spreading Palliative Care in Public Hospitals initiative, SNI is currently leading a professional Community of Practice for Interpreters in Palliative Care. Since April 2013, the Community of Practice has provided a monthly forum via a web-based platform that enables the health care interpreters from California’s safety net hospitals to come together for professional exchange, education and support. The program has 24 members who are all professional interpreters from about a dozen public and other hospitals in California. The monthly meetings serve to reduce professional isolation and offer a safe space for interpreters to discuss common practice challenges that arise in the often isolating yet emotionally difficult work of interpreting in palliative care and other end-of-life situations. The members also benefit from the exchange of ideas, collaborative problem solving, and the sharing of resources, tools and proven best practices. The Community of Practice will continue to meet through the end of 2013.

Contact: Boris Kalanj

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Delivery System Reform Incentive Program Aggregate Report

The Aggregate Report for the second year of the 1115 Medicaid Waiver’s Delivery System Reform Incentive program has been approved by CMS. SNI is under contract with the State to write this report for each year of the program. The DY 7 report emphasizes the foundational nature of the second year of the program as a building block to the out years for delivery system improvements. The Executive Summary is available here and the full report can be accessed here.

Contact: Nermeen Iskander

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