California Health Care Safety Net Institute

SNI Bulletin: April 9, 2009




Study Looks at Underuse of Interpreters in Teaching Hospitals

A study in the February 2009 issue of the Journal of General Internal Medicine found that resident physicians at teaching hospitals underuse interpreter services, often-times relying on hand gestures, family members, or a limited number of words in the patient’s primary language to communicate. Researchers Alicia Fernandez, MD of San Francisco General Hospital and Lisa Diamond, MD, MPH of UCSF conducted interviews with residents at two hospitals, both of which purport to have advanced interpreter services. Researchers found that residents often perceive accessing interpreters to be time-consuming and inefficient, thus prefer to reserve using an interpreter only in complex situations. The study pointed to use of remote (video or voice) technology as effective in addressing concerns over time and efficiency, which 12 California public hospitals have implemented.

Upcoming Roundtable on Telemedicine

SNI and CPCA are hosting a Roundtable on Telemedicine on April 16th, 2009 from 10:00AM-3:00PM at the Oakland Hilton Airport. Speakers are Margaret Laws, Director, Innovations for the Underserved at the California Health Care Foundation and Christine Martin, Executive Director of the California Telemedicine and eHealth Initiative. Speranza Avram of Speranza Avram & Associates will moderate.

For more information refer to the SNI website or contact Mary Gregory.

SNI Hosts a Series of Specialty Care Access Webinars

SNI is hosting a series of Webinars on Specialty Care Access Improvement beginning Spring 2009. Webinars will feature speakers from California’s public hospitals that have made great inroads towards increasing access to specialty care. Details will be announced in the next SNI bulletin and on the SNI website calendar. Contact: Mary Gregory, 510-874-7104.

Senior Leadership from California's Public Hospitals taking LEAN Approach to Improve Efficiency and Clinical Care

SNI recently launched the Lean Core Measures Improvement Initiative with executive orientations at Contra Costa Regional Medical Center, Arrowhead Regional Medical Center, San Mateo Medical Center, and Ventura County Medical Center. Following the orientations, program participants will conduct Value Stream Mapping and attend Kaizen workshops to transform care processes for heart failure patients. SNI looks forward to sharing the transformation process and rapid improvement ideas with all CAPH members. Contact: Evelyn Chan or Lance Mageno, 510-874-7120.


CAPH Releases Brief on Quality Indicators in California's Public Hospitals

CAPH has produced an Issues Brief describing California public hospitals’ many efforts to provide the highest quality of care at their facilities. The brief describes how CAPH member hospitals perform on several core measures and indicates that they are meeting or exceeding the national standards on most of the core measures reported to CMS. Contact: Lance Mageno, 510-874-7120.

SNI Welcomes New Board Members

SNI is pleased to announce that Michael Powers, JD, Director of the Ventura County Health Care Agency, and Anna Roth, MS, RN, PHN, Chief Operations Officer of Contra Costa Regional Medical Center, have joined the SNI Board. Both new board members bring a wealth of experience in quality improvement and health systems management, as well as a keen knowledge of the public hospital environment. After earning a law degree from Loyola Law School, Mike Powers practiced commercial litigation then became the Health Care Agency Legal Counsel for the Office of County Counsel in Ventura County. Mr. Powers has held various leadership positions within the Ventura County Health Care Agency, now serving in the top post of Director. Mr. Powers has become a champion for performance improvement and patient safety. Anna Roth, having obtained her RN and then MS from UCSF, completed a Clinical Effectiveness program at Harvard University. Ms. Roth was the first nurse in the nation to be awarded the Institute for Healthcare Improvement’s international quality improvement fellowship. A longstanding expert in quality improvement in public hospital systems, Ms. Roth is also a member of the NAPH National Quality Council and the 2009 NAPH Fellows Advisory Committee.

SNI and CAPH Featured at National Conferences

Wendy Jameson, SNI Director, spoke at the National Hispanic Medical Association’s 13th Annual Conference, Building a Healthcare Workforce for the Hispanic Community, on March 21, 2009 in New York City. Her presentation focused on California’s local safety-net-based models of expanding coverage and enhancing the delivery system as building blocks for health reform.

Physician leaders from San Francisco General Hospital, including Dr. Tom Bodenheimer, Dr. Ellen Chen, and Dr. Hali Hammer, presented their pioneering work on panel management and the development of the “health coach” staff role to an international audience at the Institute for Healthcare Improvement’s 10th Annual Summit on Redesigning the Clinical Office Practice. Materials from their presentation titled “A Training Lab for Health Coaching in Primary Care” can be accessed here.

CHCF Health Care Leadership Program Scholarships Available: Deadline May 15

CHCF is soliciting applications from clinical leaders interested in participating in a part-time, two-year fellowship to become stronger and more effective change agents. CHCF is strongly encouraging participation from public hospitals, such as those in southern and central California, that have not participated heavily in the past. CAPH members are eligible for scholarship support. Potential candidates are those who have experience in management and have demonstrated the potential to provide strong leadership in their institution. Applications are due May 15, 2009. Inquiries about the program should be directed to CHCF.

SNI Welcomes Angelina Ramos Event Planner/Administrative Assistant, to the Staff

SNI is pleased to announce that Angelina Ramos has joined the staff as of March 23 as our new Events Planner/Administrative Assistant. Angelina has responsibility for planning and executing multiple SNI events and meetings, as well as providing administrative support. In addition to having extensive experience in these critical areas, Angelina has been involved in local political campaigns and undertaken extensive volunteer work. Contact: Angelina Ramos, (510) 874-7102.

Upcoming Events and Deadlines

April 14th, 2009: Deadline for CAPH members to submit CHART improvement grants. Contact: Lance Mageno, 510-874-7120.

May 7, 2009: SNI Board Meeting, 10:00 - 2:00, Scott's Seafood Restaurant, Jack London Square, Oakland.

May 27, 2009: Spreading Palliative Care in Public Hospitals Initiative Grantee Meeting, 9:30 AM-4:00 PM, Marriott International in Los Angeles. Contact: Monique Parrish.

May 29, 2009: CAPH/SNI Quality Leader’s Day, 10:00 AM-3:00 PM at LAC+USC Clinic Tower in Los Angeles. Contact: Lance Mageno, 510-874-7120.

July 16-17, 2009: Quality in Healthcare Interpreting Conference in Oakland, co-sponsored by SNI. Contact: Beverly Treumann