California Health Care Safety Net Institute

SNI Bulletin: September 10, 2009

e-Prescribing Goes Live at Kern and San Mateo Medical Centers

SNI’s e-prescribing initiative, being piloted in four public hospitals throughout California in their outpatient pharmacies and clinics, is now in its final implementation phase. Kern Medical Center went live on August 31st using DrFirst e-prescribing software as a stand-alone product, and roll-out is expected to continue at a rapid rate with the goal of approximately 100 clinical users going live over the next few months. San Mateo Medical Center (SMMC) also went live with e-prescribing in April as part of implementing their ambulatory electronic medical record using eClinicalWorks. SMMC launched e-prescribing at all 11 outpatient clinics with 150 physicians electronically prescribing, sending approximately 550 prescriptions daily to both the SMMC outpatient and community pharmacies. This initiative is funded by the Blue Shield of California Foundation,

Contact: Mary Gregory, (510) 874-7104

California Public Hospitals Make “America’s Best” Ranking

Rancho Los Amigos, LAC+USC Medical Center, UC Irvine, and UC San Diego have made the list of “America’s Best Hospitals” in an annual ranking of the nation’s top-notch medical centers by U.S. News & World Report. Rancho made the “Top 20” list of Rehabilitation Hospitals where it has remained for two decades, and LAC+USC made the “Top 50” list of Ophthalmology Hospitals. UC San Diego ranks in the “Top 15” for Respiratory Disorders and in the “Top 50” for Kidney Disorders, while UC Irvine ranks in the “Top 30” for Gynecology. Now in its 20th year, the ranking looks at how well a hospital handles complex and demanding situations. Only 174 hospitals were ranked in one of 16 specialties from nearly 5,000 considered for the survey.

SNI Leads National “Community of Practice” on REAL Data Collection and Use

SNI is pleased to collaborate with Diversity Rx on a Community of Practice (CoP) for Race, Ethnicity and Language (REAL) Data Collection and Use, funded by The California Endowment. This eight-month learning community, which will bring together 12-15 national experts on REAL data collection and use, will explore how accurate data on patient characteristics such as race, ethnicity, gender, language, and literacy can be used to ensure equitable care for all patients. SNI and Diversity Rx will kick off the CoP with a discussion of the recently released Institute of Medicine Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. This report examines approaches used to collect patient demographic data and calls for health care organizations to amend their current practices to ensure that the data collected is granular enough to be meaningful. The report recommends that hospital systems continue to use the standard Office of Management and Budget (OMB) race categories but add additional ethnicity categories reflective of their patient population. In addition, health care organizations are urged to update their language data collection practices to include the patients’ need for an interpreter.

Contact Erin Bowman, (510) 874-7119

Health Care Interpreter Network Produces Training Video on Using Qualified Interpreters

California’s public hospitals are leaders in providing high quality interpretation to limited English proficient patients. Twelve California public hospitals have employed remote video and voice technologies to increase patient access to high quality, efficient interpretation. Several additional California public hospital systems are slated to implement video medical interpreting in the near future. As innovators in providing high quality interpretation, the Health Care Interpreter Network, in partnership with Kaiser Permanente, developed a 19-minute video for clinical staff that outlines protocols and best practices for accessing and using qualified interpreters. The film, which features Contra Costa Health Services Director Dr. William Walker, as well as interpreter staff at Contra Costa Health Services, offers demonstrations and tips for using both in-person and remote interpreters. Click here to order up to five free copies of this video.

Coming this October: First Outpatient Improvement Leaders Workgroup for the Seamless Care Center Initiative

The Seamless Care Center Initiative to spread improvements in primary care is poised and ready to launch this coming October, pending funding. Employing new research-and-development-style workgroups for CAPH-member quality improvement leaders statewide, SNI will work with CAPH members to address issues of their choice. SNI encourages all interested improvement thinkers from across the CAPH membership to participate in the workgroups, regardless of whether their whole organization is a full partner in the Initiative. Potential topics for the first workgroup include: 1) Developing the Panel Manager role in the care team, 2) Building quality improvement capacity in residency-based clinics, 3) Efficient clinic flow in resident-staffed clinics, or 4) Building engagement with physicians for quality improvement.

Contact: Sasha Morduchowicz, (510) 874-7121

Four of California’s Public Hospitals Complete First Wave of Lean Transformation to Improve Heart Failure Care

The first half of SNI’s Lean Core Measures Improvement Initiative has now been completed at each of the four participating hospitals: Contra Costa Regional Medical Center (CCRMC), Arrowhead Regional Medical Center, San Mateo Medical Center, and Ventura County Medical Center. With the excellent coaching of Rona Consulting Group, all participants were focused on transforming care processes for heart failure patients, to be measured by improvements in the publicly-reported CMS Heart Failure Core Measures and 30-Day All Cause Readmission Rates. One exciting example of the many rapid changes happening through the Lean Initiative is the creation and opening of the Patient and Family Healthcare Partnership Center within CCRMC, formed in partnership with the National Alliance of Mental Illness of Contra Costa. This new support center, which was conceived of and opened in one week, is dedicated to improving the experience of patients with mental illness, and their families, in the medical care system.

Contact: Evelyn Chan, 510-874-7106

September 30th Event on Techniques to Engage Clinicians in Improving Care

The California Primary Care Association (CPCA) is hosting an event sponsored by the California Improvement Network (CIN), which is intended for clinical QUALITY leaders to understand the key principles underlying successful clinician engagement. Dr. Howard Beckman, the Medical Director of the Rochester IPA, and Clinical Professor of Medicine and Family Medicine at the University of Rochester School of Medicine and Dentistry is the featured speaker at this event. Registration is $25, and space is limited. Click here to register for this event.

Medication Optimization Diffusion Grants: Letters of Intent Due October 2nd

The Center for Technology and Aging’s first grantmaking initiative, The Medication Optimization Diffusion Grants Program, is soliciting letters of intent from organizations that are interested in expanding the adoption of technologies that help improve medication use among older adults (60+ years old). Total funding available for this grant program is $500,000. Up to six grants will be awarded, and awarded projects are expected to commence in January 2010. Funded projects will expand the use of beneficial technologies in medication reconciliation, medication adherence, and/or medication monitoring. For an overview of this content area, please read the Center’s position paper, Technologies for Optimizing Medication Use in Older Adults. The Grant Application Guidelines are also available for review, or visit the Center for Technology and Aging website.

SNI Employment Opportunity: Senior Program Associate for Quality Improvement

Click here to see the full job description.

Upcoming Events

Institute for Healthcare Improvement: Kaiser Scholarships for CAPH-member staff are still available for these featured IHI events. Contact: Angelina Ramos, (510) 874-7102.

· Oct. 5- 6 San Francisco, CA: Reengineering the Operating Room to Improve Hospital-Wide Efficiency and Quality.

· Oct. 27- 28, Boston, MA: Building a Quality Measurement System that Works.

· Oct. 29- 30, Boston, MA: The Triple Aim, Optimizing Health Care Resources for the Good of a Population.

· Dec. 6- 9, Orlando, FL: 21st Annual National Forum on Quality Improvement in Health Care.

Sept. 14, 9AM-10AM: SNI-hosted Webinar on Fuller Scope of Practice. Kern Medical Center will present on pharmacy clinics and mini-fellowships. Click here to join the event; the password is “scope”. Contact: Mary Gregory, (510) 874-7104.

Sept. 15, 11AM: NAPH/SNI Distance Learning Call on Coordinating Psychiatric and Primary Care in Public Hospitals. Register here. Contact: Josel Bernardo, (202) 585-0105.

Sept. 15: IHI's Improvement Map, an interactive, web-based tool to help hospital leaders improve quality while lowering costs, will be available on the IHI website.

Oct. 1, 8:30AM-2:30PM: The California Quality Collaborative in partnership with the California Improvement Network hosts ABC’s of Quality Improvement at the Long Beach Hilton. Registration is free. Contact: Roza Do, (213) 239-5049.

Oct.26, 10AM-3PM: CPCA and SNI-hosted Round Table on Fuller Scope of Practice to Expand Specialty Care Access at the Hyatt Regency in Sacramento. Contact: Mary Gregory, (510) 874-7104.

Nov. 4, 10AM- 4PM: Save the Date for the Summit to Accelerate Operational Efficiency in Safety-Net Hospitals at The California Endowment in Oakland. Contact: Angelina Ramos, (510) 874-7102.

Nov. 11, 10AM-3PM: CPCA and SNI-hosted Round Table on Fuller Scope of Practice to Expand Specialty Care Access at the Burbank Airport Marriott Hotel. Contact: Mary Gregory, (510) 874-7104.

Dec. 2-4: CAPH Annual Conference, including SNI 10th Anniversary Celebration, held at the Monterey Plaza Hotel in Monterey. Contact: Alysia Nero, (510) 874-7100.