California Health Care Safety Net Institute

SNI Bulletin: APRIL 15, 2010

CAPH Hospitals Making Significant Efficiency Gains Featured in Recent CHCF Publications

On March 31st, the California HealthCare Foundation (CHCF) released two reports on improving efficiency in public hospital systems and private safety net hospitals. The first paper, Improving Efficiency in the Safety Net: Management Engineering Practice and Cases by David Belson, Ph.D., highlights several case studies where management engineering techniques have made an impact on patient flow and throughput. The second document, Towards a Better Patient Experience: Reengineering California's Safety-Net Clinics by Ruth Brousseau, Ph.D., reviews the Patient Visit Redesign model, which has been implemented in 13 CAPH-member systems through SNI. Several CAPH-member hospitals systems were featured in both reports and shown to have made significant improvements.

Contact: Wendy Jameson

Six CAPH Members Win Awards for Outstanding Quality of Care

Contra Costa Regional Medical Center (CCRMC) was recently featured on KPIX-TV and KCBS Radio for providing high-quality cancer services to patients regardless of their insurance status. As a result of its outstanding work, CCRMC was awarded the 2009 Outstanding Achievement Award from the American College of Surgeons’ Commission on Cancer, one of only three California hospitals to receive this honor. The hospital reports they’ve experienced a 30% increase in cancer patients within one year, an area where there hadn’t been much growth in recent years.

Also, Riverside County Regional Medical Center, San Mateo Medical Center, San Francisco General Hospital, Alameda County Medical Center, and Santa Clara Valley Health and Hospital System received the prestigious 2010 Kaiser Permanente James A. Vohs Award for Quality for their ALL/PHASE programs. With the overarching goal of reducing cardiac risk by managing severe chronic diseases, all hospitals reported significant decreases in blood sugar, LDL cholesterol, and blood pressure, with patients adhering to their prescribed medication regimens. Read more about the ALL/PHASE program here.

Information Technology Adoption Center for California Public Hospital Systems Supports Adoption and Meaningful Use of HIT

The California Health Information Partnership Services Organization (CalHIPSO), formerly known as Cal-REC, officially received its grant award notice in February from the Office of the National Coordinator for Health Information Technology and is the regional extension center (REC) for all of California except for Los Angeles and Orange counties. The state of California received the largest amount of REC funding in the country. SNI will serve as the local extension center (LEC) for CAPH-member public hospitals through a new program called the Information Technology Adoption Center for California Public Hospital Systems, or ITAC. ITAC will provide direct technical assistance to CAPH-members to adopt, implement and upgrade their EHRs in ambulatory care. ITAC will be holding two convenings for CAPH members to learn about the services available in order to achieve meaningful use. The first will be held in Northern California on May 7, and another in Southern California on May 14.

Contact: Seraphin Nicholson

Benefits and Challenges Implementing e-Prescribing in Public Hospitals Featured in Lumetra Article

Lumetra Healthcare Solutions, a consulting firm that has worked with SNI to provide technical assistance and conduct a return on investment analysis for SNI’s e-Prescribing Initiative, recently featured the e-Prescribing pilot in their newsletter.Adopting electronic prescribing at Kern Medical Center and San Mateo Medical Center has reduced pharmacy crowding, and patients pick up medications quicker based on the rapid routing of prescriptions, especially to the internal hospital pharmacies.

Contact: Mary Gregory

Quality Leaders Awards Webinar Series: SFGH's Automated Telephone Diabetes Self-Management Support Model

The next Quality Leaders Awards (QLAs) webinar will be held on Wednesday, April 21st from 1:30 to 2:30 pm. Participants will learn about San Francisco General Hospital’s Automated Telephone Self-Management Support Model for Diabetes, which earned them a Top Honors award for the 2009 CAPH/SNI QLAs. The presentation will be conducted by Dean Schillinger, MD, a practicing primary care doctor at San Francisco General Hospital, UCSF Associate Professor of Clinical Medicine and Director, Director of the California Diabetes Program and of the Center for Vulnerable Populations Chair. Co-presenting is Dr. Schillinger’s associate, Margaret Handley, Adjunct Professor at UCSF and Co-director of the UCSF Collaborative Research Network.

Visit the SNI Event Calendar for more information about this webinar, or contact Norma Batongbacal at (510) 874-7116 to register. The recording of the March 26 webinar on Kern Medical Center’s Clinical Pharmacists Involvement in Direct Patient Care is now available on the SNI website.

Announcing Participating Hospital Systems in SNI’s Seamless Care Center Initiative

SNI is pleased to announce that the following CAPH-member hospital systems have been chosen to participate in the Seamless Care Center Initiative: Alameda County Medical Center, Riverside County Regional Medical Center, San Mateo Medical Center, Los Angeles County + USC Medical Center, and Rancho Los Amigos National Rehabilitation Center. All participating organizations will report data on clinical quality, access, and efficiency measures. Alameda and San Mateo will specifically work on access to care and efficiency with Coleman Associates, while Riverside and Los Angeles clinics will work with SNI and their local QI leaders on managing chronic care, patient communications, and medical-home-related clinical quality.

Contact: Sasha Morduchowicz

New CHCF Reports and Interactive Maps Shine Light on Chronic Illness in California

A recent report shows that 36% of adults and 16% of children had at least one chronic health condition in 2007, and that treating these conditions accounts for more than 70% of all U.S. medical costs. Two reports and an interactive mapping tool, based on the 2005 and 2007 California Health Interview Surveys (CHIS) data, provide information about the extent of chronic disease in California and identify those areas that are bearing the heaviest burden. In addition to charting chronic conditions such as diabetes and hypertension, these new editions introduce additional measures, including adult psychological distress, active asthma, and congestive heart failure.

Resources on Measuring and Improving Patient Experience

In October 2009, SNI and NAPH hosted a web conference on Measuring and Improving Patient Experience in Primary Care. Susan Edgman-Levitan, PA, Executive Director of the John D. Stoeckle Center for Primary Care Innovation presented a study conducted by the Stoeckle Center and RAND that assessed both the use of and potential barriers to collecting patient experience of care data by safety net organizations in California. The presentation also included information on the benefits to using the Clinician and Group CAHPS survey, and quality improvement resources for improving patient experience. Click here to access the presentation.

In related news, the California Quality Collaborative (CQC) Guide to Improving Patient Experience has recently been revised. Since 2006, CQC has led 15 California medical groups and IPAs in three separate year-long efforts to improve the patient experience. These learnings and the accompanying literature have been summarized into an easy-to-use guide, which includes 9 High Impact Changes that lead to an improvement in patient satisfaction. The guide also includes a new section on tactical and strategic changes to support physician practices in improving the patient experience.

Applications Available for Excellence in Medication-Use Safety Award

The Award for Excellence in Medication-Use Safety is the only award program to honor a pharmacist-led multidisciplinary team for its significant institution-wide system improvements relating to medication use. The $50,000 award, which is sponsored by the Cardinal Health Foundation, nationally recognizes pharmacy professionals who have assumed a leadership role in promoting safety in the medication-use process. The award will also honor two finalists, who each receive $10,000. Visit the American Society of Health-System Pharmacists Foundation website for application details, or visit the SNI website for more information. The deadline to apply is April 29.

Upcoming Events & Deadlines

· Apr. 28:
St. Mary’sMedical Center Seventh Annual Palliative Education Day in San Francisco. Open to members of palliative care teams from all hospital systems.

· Apr. 30: IHI’s Early Access to Palliative Care: Active Learning Through Live Case Studies in Seattle. IHI scholarships are available to cover tuition and travel expenses. Visit the SNI Website to apply, or contact Angelina Ramos.

· May 13: Spreading Palliative Care Annual Grantee Meeting, will be held at The California Endowment Conference Center in Oakland from 9:30 am to 4:00 pm. CAPH members without a Palliative Care grant may also attend. RSVP to Monique Parrish, Program Manager. For $169 the American Academy of Hospice and Palliative Medicine also has available a previously recorded webinar on billing and coding in palliative and hospice care.

· May 18: SNI and the California Improvement Network are co-hosting the ABC's of QI, a free one day training focusing on the basic concepts of quality improvement. Register here, or contact Sasha Morduchowicz at (510)-874-7121.

· June 4: SNI Summit on Quality Improvement in Graduate Medical Education, 12:30 pm to 5:30 pm at the UCSF Mission Bay Campus in San Francisco. For CAPH-member organizations only. Contact: Sasha Morduchowicz at (510) 874-7121.