SNI Transitions to Its Next Chapter

With full implementation of the Affordable Care Act only months away, the CAPH Board is reexamining the fundamental role and offerings of the Safety Net Institute (SNI) in light of the new health care landscape facing public hospital systems.

The Board has engaged a national leader, Bruce Vladeck PhD, to work with us and help re-imagine SNI and develop the next chapter for the organization. Bruce is currently a consultant for Nexera Inc., and has extensive experience and expertise on a wide range of matters for health care organizations. He previously served as HCFA (now CMS) Administrator under President Clinton during the Clinton reform efforts, served on the Board of the New York City Health and Hospital Corporation, served as Interim President of the University of Medicine and Dentistry of New Jersey which ran a large public hospital in Newark, and is a member of the Institute of Medicine. He will be speaking with CAPH leaders from every hospital and health system, and working with both the CAPH and SNI Boards to complete the development of the next chapter of SNI by mid-June 2013.

As SNI’s Interim Executive Director during the transition, I am working with CAPH President and CEO Melissa Stafford Jones and SNI staff to share our experience and expertise with Bruce, as well as continue the facilitation of current programs during this transition period, including DSRIP Reporting, Patient Experience, the Lean Learning Community, IHI Scholarships and ITAC – our EHR adoption project.

If you have any questions, please don’t hesitate to contact me.

-Nancy Oswald, PhD

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15 primary care clinics from California’s public hospital systems are participating in the SNI-led CG-CAHPS Improvement Network, partially funded by a matching grant from the California HealthCare Foundation. The Network aims to increase the skills of providers and staff to communicate empathy and caring, boost the clinics’ mastery of quality improvement skills relevant to patient experience, and ultimately improve Clinician and Group CAHPS survey (CG-CAHPS) scores.

The key component of the program is The Language of Caring, a skills-based curriculum to be rolled out over nine months in the participating clinics. The program will strengthen the staff communication skills so that their caring and compassion can be more effectively and frequently felt by their patients and colleagues. The Network builds on the successful rollout of the CG-CAHPS, which is now being implemented in all public hospital primary care clinics.

Contact: Boris Kalanj

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Seven improvement teams from San Joaquin General Hospital (SJGH), Arrowhead Regional Medical Center (ARMC), and Riverside County Regional Medical Center (RCRMC) made important strides in implementing team-based care and promoting patient engagement and self-management support through their participation in the Medical Home Collaborative. During the nine-month collaborative, the quality of care patients received improved as seen by the following metrics:

• The percentage of diabetic patients whose most recent LDL cholesterol was in control (<100) increased from 62% to 65%
• The percentage of diabetic patients whose most recent blood pressure reading was in control (<140/90) increased from 66% to 72%
• The percentage of diabetic patients with documented self management goals increased from 19% to 65%
• The percentage of diabetic patients with documented screening for depression increased from 38% to 60%

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Public hospitals have made significant progress in improving sepsis protocols through SNI’s 2-year Sepsis and CLABSI Collaborative, generously funded by the Blue Shield of California Foundation. With guidance from national experts and participation in statewide convenings, public hospital systems have developed individualized data collection methods and defined operational practices for elements of the sepsis resuscitation bundle. Defining these methods is a critical step to improving sepsis infection and mortality rates. The Sepsis and CLABSI Collaborative will host a final in-person session before concluding in June 2013.

Contact: Rosemary Phu

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Marianne Gausche-Hill, M.D., lead investigator at The Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed), was honored by the Emergency Medical Services Authority (EMSA) with a Distinguished Service Award for her contributions and sustained statewide leadership, research and education in improving emergency medical services (EMS) for children. Established in 2007, the annual EMSA awards honor and recognize exceptional acts and service by individuals who work or volunteer in California's emergency medical system. Dr. Gausche-Hill was one of 39 individuals to receive the award.

Three public hospital systems – Alameda County, Natividad, and San Mateo Medical Centers – have each been approved for Always Events® recognition by the Picker Institute. Always Events® are a national organizing principle for improving the delivery of patient-and family-centered care that are aspects of the patient and family experience that should always occur when patients interact with health care professionals and the delivery system.

Contact: Boris Kalanj

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