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Message from the Executive Director
2010 has been a year of remarkable and tangible results from all the incredible work that California public hospital systems, in partnership with SNI, have undertaken to transform the delivery of care to their diverse patient populations. Having launched our Seamless Care Initiative to improve clinical quality and operational efficiency in public clinics, we’re already seeing an average 40% reduction in no-show rates. Readmission rates for congestive heart failure are declining in all four Lean Core Measure hospitals. Palliative care services have been spread to 68% of California public hospitals, compared with just 44% nationally, with even more hospitals adopting palliative care in the coming year. More than 500 public hospital outpatient providers have been enrolled into SNI’s Information Technology Adoption Center, making CalHIPSO the #1 regional extension center in the nation in terms of provider enrollment. Towards our goals of spreading innovation, SNI has launched the first-ever Quality Leaders Awards Webinar Series, highlighting three of the most promising practices among QLA honorees.
While I am so proud of these accomplishments, in the coming years public hospital systems must accelerate the pace of change, and take on multiple change efforts simultaneously. With the promise of health care reform, and opportunities through the Section 1115 Medicaid Waiver to expand coverage and achieve even greater delivery system transformation, SNI will be considering how we can step up, reach out to critical funders and partners, and ensure that public hospital systems can achieve our mutual vision of ensuring access to integrated, high-quality, equitable care and improving population health.
From all of us at SNI, we wish you a healthy and happy 2011.
-Wendy J. Jameson, SNI Executive Director
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SNI Spotlight on Patient Experience and System-Wide Transformation at CAPH Annual Conference
This past December, public hospital system and other health care leaders had an opportunity to examine critical issues in transforming health care to prepare for health care reform at the California Association of Public Hospitals & Health Systems (CAPH) Annual Conference. A Focus on the Human Experience of Health Care: The Key to Improved Outcomes, the special members-only workshop, focused public hospital leaders on the human experience of health care as the key to improved patient satisfaction. ExperiaHealth Chief Experience Officer M. Bridget Duffy, MD, along with her colleague Carrie Brady, JD, MA, provided key insights and tools to connect quality, safety, and the patient and employee experience, the most important foundation to build on as public hospital systems develop plans for comprehensive delivery system transformation.
The last session of the conference, Paving the Road to Health Care Reform: The Journey Towards System-Wide Transformation of the Safety Net, aimed to inspire and stimulate attendees’ thinking about how to prepare for and manage the enormous system-wide changes public hospitals will undertake in the next three to five years under the Section 1115 Medicaid Waiver and preparing for health care reform. Featured speaker Dr. Bruce Siegel, newly inaugurated CEO of the National Association of Public Hospitals and former public hospital system leader, shared his focus on creating organizational culture change to achieve public hospital system transformation. Dr. David Labby and Rebecca Ramsay of CareOregon shared their journey towards becoming an organization now achieving the Triple Aim (controlled costs, population health, patient satisfaction) for their patients. The session culminated in a panel of three public hospital leaders heading up system-wide culture change using Lean to provide more efficient, high-quality, patient-centered care.
Contact: Norma Batongbacal or Mary Gregory
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Quality Leaders Awards Honors Top Innovations, Webinar Series Kicks-Off
The CAPH/SNI Quality Leaders Awards (QLA) program showcases the best innovations among California's public hospitals and public clinics. Honored at the CAPH Annual Conference on Dec. 2nd, this year’s awardees addressed five critical focus areas: Clinical Quality Improvement, Improvements in Patient Experience, Coordinated Systems of Care, Political Effectiveness and Community Support, and Efficiency and Access, each crucial towards achieving the aims of health reform. Top Honors were awarded to Alameda County Medical Center’s Early Identification and Treatment of Community-Acquired Pneumonia, San Mateo Medical Center’s Community Health Network for the Underserved and UC Davis Health System’s Collaborative Chemotherapy Efficiency Project. Honorable Mention winners included Contra Costa Regional Medical Center’s ED Patient Flow Redesign, Olive View-UCLA Medical Center’s Medical Walk-In Process Flow, and San Francisco General Hospital & Trauma Center’s OR Efficiency Project. The Kaiser Permanente Clinical Systems Development award went to Ventura County Medical Center for their Behavioral Health Service Integration into Primary Care. Full descriptions of the QLA program and winning entries can be found on the SNI website. In conjunction with the QLA program, SNI is kicking-off the QLA Webinar Series by featuring Alameda County Medical Center’s QLA entry with presentation led by Jeanette Cotanche, Chief Quality and Compliance Officer. This first webinar will take place in February.
Contact: Norma Batongbacal
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Addressing Patient and Family Engagement at the Quality Leaders Forum
On November 10, 2010, SNI held the second Quality Leaders Forum of the year, a gathering of quality improvement experts from CAPH-member hospitals to network, share resources and best practices, and explore opportunities for collaboration. One of the topics discussed was patient and family engagement - a key challenge for all of us in health care area, as we strive to build high-quality health care systems structured around and responsive to the people who use them. A major highlight of the Forum was the panel of patients, families, community advocates and staff from Contra Costa Regional Medical Center (CCRMC), which presented on CCRMC’s methods of engaging patients and their families in organizational quality improvement, operations and governance. A short video illustrates their success in redesigning CCRMC’s psychiatric emergency services through a joint effort by doctors, nurses, administrative staff and - most notably –patients, families, and community advocates.
Contact: Boris Kalanj
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SNI and CAPH Members to Receive Funds to Further Spread Palliative Care and Improve REAL Data Collection Efforts
Following the success of a project to establish and expand palliative care consultation services in 12 California public hospitals, the California HealthCare Foundation (CHCF) recently approved up to $1,457,000 in additional funding that will ultimately ensure that all CAPH-member public hospitals can offer palliative care services to their most fragile patients in their time of need. Eligible hospitals under the new grant are Harbor/UCLA Medical Center, Kern Medical Center, Natividad Medical Center, San Joaquin General Hospital and Ventura County Medical Center. SNI and UCSF’s Palliative Care Leadership Center will continue to partner with CHCF and all participating public hospitals in implementing this initiative. The request for proposals for the two-year grants will be available on Jan. 5th. Letters of intent to apply will be due by Jan. 12th, with full proposals due March 25th.
In addition, SNI has also received a $10,000 grant from CalHIPSO (California Health Information Partnership and Services Organization) to help integrate collection of accurate patient data on race, ethnicity and language (REAL) into the training curricula supporting EHR adoption and meaningful use. This is a step toward SNI’s larger goal to help build systems of care capable of collecting valid and reliable patient demographic data as a foundation for evaluating equity of care and addressing disparities.
Contact: Boris Kalanj
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The Seamless Care Center Initiative Year In Review
As SNI kicks off the second year of our Seamless Care Center Initiative, we are seeing real results in helping transform primary care in five public health systems across the state, thanks to generous funding from the California HealthCare Foundation. At LAC +USC Medical Center, front-line staff are maximizing teamwork to increase access and training on their chronic disease registry to create a patient-centered medical home. Only 5 months into the Seamless Care program, 64% of diabetic patients at LAC + USC have achieved an A1c < 8%. At San Mateo Medical Center, teams have completed work on Patient Centered Scheduling with Coleman Associates and are maintaining an average no-show rate of 10.7% and average third-next-available appointment at 8.7 days. One of the clinics in Riverside County has shown a 20% increase in the number of diabetic patients with blood pressure < 130/80. The work that Riverside County teams are doing to improve diabetes care at the population level has heightened senior leader awareness that success and sustainability are contingent upon training their own cadre of quality improvement leaders. Select staff from Riverside County, LAC + USC Medical Center and Rancho Los Amigos National Rehabilitation Center participated in a “train-the trainer” workshop on effective clinician-patient communication and facilitation of patient health behavior change and self-management through the Institute for Healthcare Communication. Upon certification, these institutions will have their own internal experts with the ability to train hundreds of staff on these techniques. At Alameda County Medical Center, involvement with Seamless Care’s High-Impact Management Program has increased cohesion among the management team. SNI is very pleased with the improvement work that each of the participating organizations have achieved thus far and is confident that with the support of leadership and strong clinic improvement teams, the program will continue to improve patient care.
Contact: Denise Gonzalez
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ITAC Extension and Medi-Cal Meaningful Use Incentive Payment Registration
The timeline for Regional Extension Centers’ (RECs) has been extended to four years to attain their priority primary care provider targets, which is better aligned with the timing of meaningful use implementation. CalHIPSO is California’s REC (except for Orange and Los Angeles counties), and SNI’s ITAC is the Local Extension Center for California public hospital priority primary care providers. In addition, the 90/10 federal match will also be extended from two to four years, so that RECs will need to fund only 10% of the first four years in order to receive the 90% federal match.
The first step towards receiving Meaningful Use Incentives is also coming soon: Registration for Medi-Cal Meaningful Use Incentives started Jan. 3rd. Register for Medi-Cal incentives here. In order to register for Medi-Cal incentives, all providers must register first with CMS. Medi-Cal will be providing a webinar to answer registration questions in mid-January.
Contact: Seraphin Nicholson
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The Waiting Room Steps Inside One California Public Hospital, Others Featured in Urgent Matters
An exciting project is taking place at Highland Hospital, part of the Alameda County Medical Center. Called The Waiting Room, the effort is “a social media/documentary hybrid that tells the story of a county ‘safety-net’ hospital in Oakland, California.” Please see and hear the many compelling stories on The Waiting Room website.
Also, Urgent Matters, a national initiative dedicated to finding, developing and delivering strategies to improve patient flow and reduce emergency department (ED) crowding, has featured two CAPH member hospitals in their current Urgent Matters E-Newsletter. Kern Medical Center launched the Care Transitions & Coordination (CT&T) program, which has helped more than 120 “frequent users” obtain reliable social and medical services, significantly reducing their use of the ED. UC San Diego Medical Center conducted a trial in the ED using an Internet-based, electronic referral system called IMPACT-ED (Improving Medical Home and Primary Care Access to Community Clinics through the ED.) The trial resulted in a more than 20% increase in kept follow-up appointments post ED discharge.
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Public Hospital Leader Honored by Kaiser Permanente and IHI
San Mateo Medical Center’s Chief Medical Officer, Chester J. Kunnappilly, MD, was selected by Kaiser Permanente (KP) and the Institute for Healthcare Improvement (IHI) to represent the 1000th IHI scholarship offered by Kaiser’s Community Benefit division. Dr. Kunnappilly, an IHI-KP scholar, was featured during a commemoration of the 1000th Scholarship milestone at IHI’s Annual National Forum in December. He represented the over 300 CAPH-member staff, clinicians and administrators who have benefited from the IHI-KP scholarship program through SNI. .In addition, he was also a featured panelist on the Safety Net Scholar Panel, Innovation in Care Delivery to Achieve Equity, at the IHI Forum. Dr. Kunnappilly has participated in IHI’s programs on the Triple Aim and Spreading Change, among others, and credits the programs with helping him and his organization to make considerable strides in quality improvement.
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Events
- Jan 19, 11am: NAPH Webinar Accountable Care Organizations: Back to the Future. Log-in and register on the NAPH website.
- Jan. 27, 12pm to 1:30pm: Tools for Measuring and Monitoring Equity in Quality: The Hospital Perspective webinar on hospitals and health disparities by Disparities Solutions Center (DSC). Register here.
- Feb. 16, 9am to 10:30am: IHI’s Self Management and Patient Engagement-An Opportunity to Optimize Outcomes, first of a three-part web-based program. Contact: Angelina Ramos at (510) 874-7102.
- Feb. 9 - 11: IHI’s Managing Hospital Operations-An Introduction to Management Science is a five-month professional development program in Cambridge, MA. Contact: Angelina Ramos.
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