California Health Care Safety Net Institute

SNI Bulletin: DECEMBER 17, 2009

Message from the Director

In celebrating SNI’s 10th anniversary at the close of 2009, I’ve had a chance to both reflect on an amazing year of change, and look back on a decade of tremendous evolution for SNI and public hospital systems. While in the early days of SNI we developed our areas of focus, it’s clear from reviewing the accomplishments of the last 10 years that all of this work has aimed at ensuring that more people—especially those most affected by health disparities—receive effective, efficient and respectful health care regardless of their ability to pay. I invite you to see for yourself what we’ve been up to by viewing SNI’s new video, Making A Difference, to be available soon on our website (contact Norma Batongbacal for a copy).

In 2009, we launched major initiatives aimed at transforming practice, building healthcare homes and ensuring coordinated care at California public hospital systems. Using Lean technology, four hospitals are improving patient safety, health care outcomes and efficiency with promising early results, such as major reductions in avoidable admissions. Through our Seamless Care Initiative, several CAPH members are enhancing the way their outpatient clinics provide primary care to ensure excellent access, effective chronic disease care and a healthcare home. SNI also conducted a major study on what it takes to improve accurate, consistent collection and use of patient race/ethnicity/language (REAL) data, to match services to patient needs and maintain equitable care.

If there is any take-home message for me at the end of SNI’s first decade, it’s that it takes teamwork and partnership to transform health care delivery and ultimately patients’ lives. On behalf of SNI, I would like to express my admiration and tremendous gratitude to the amazing people leading and working in public hospital systems, our funders, our board members, our partners, and of course our fabulous SNI and CAPH staff.

All of us at SNI wish you a healthy and happy holiday season and New Year.

-Wendy J. Jameson, SNI Director

NAPH/SNI Series of Technical Assistance Calls on Improving Primary Care

Beginning in July 2009 NAPH and SNI hosted a series of online conference calls to discuss effective solutions to important issues in the provision of outpatient care services with the national public hospital audience. Speakers from the CAPH membership included Santa Clara Valley Medical Center’s Margo Maida, San Francisco General Hospital’s Dr. Hal Yee, the San Francisco Department of Public Health’s Dr. Lisa Johnson, and San Mateo Medical Center’s Drs. Chester Kunnappilly and Michael Aratow. SNI is grateful to these individuals for sharing their leadership and expertise. Click on the following links to access the presentations from the calls:

1. Margo Maida - "Integrating Chronic Care and Business Strategies in the Safety Net: A Pilot Project at California Safety Net Hospitals"

2. Hal Yee, MD, PhD - "Improving Access to Specialty Care in Safety Net Hospitals"

3. Measuring and Improving Patient Experience in Primary Care Webinar

4. Lisa Johnson, MD - "Becoming Medical Homes: Steps Towards Transformation of Primary Care"

5. Chester Kunnappilly, MD, Michael Aratow, MD - "Making HIT work in Primary Care: Improving Information Management to Improve Quality"

California Public Hospitals Honored as Quality Leaders

For over 15 years, the CAPH/SNI Quality Leaders Awards has acknowledged more than 300 innovative programs among California's public hospitals. Honored at the CAPH Annual Conference on Dec. 3rd, this year’s awardees addressed four critical focus areas: Clinical Quality Improvement, Improvements in Patient Experience, Creating Equitable Health Systems, and Political Effectiveness and Community Support. Top Honors were awarded to San Francisco General Hospital’s Automated Telephone Self-Management Support Model for Diabetes, Ventura County Medical Center’s Improving Critical Care Outcomes: The Future of ICU Data Collection and Santa Clara Valley Medical Center’s Seismic Safety Project. Honorable Mention winners included Los Angeles Harbor/UCLA Medical Center’s Concurrent ORYX Review Program (CORP), San Francisco Department of Public Health’s Active Patient Panels: Use in Patient Capacity Assessments and QI Efforts, and UC Davis Health System’s the Toolkit for the Medical Home. The Kaiser Permanente Clinical Systems Development award went to Kern Medical Center for its Impact of Clinical Pharmacists Involvement in Direct Patient Care as Mid-Level Practitioners program. Full descriptions of the QLA program and winning entries can be found on the SNI website.

Report Highlights California Public Hospitals as Models for Providing Quality Healthcare Interpreting

A recently released report on improving health care for individuals with limited English proficiency (LEP) suggests that California public hospitals “serve as models of promising practices that can be adopted by other hospitals and health systems across the country.” The research was conducted by the Health Research and Educational Trust (HRET), Boston University, and Northwestern University with support from The California Endowment. One researcher on this report joined SNI Director Wendy Jameson and several California public hospital language services champions on a panel at the 2008 National Conference on Quality Health Care for Culturally Diverse Populations conference. The panel explored the synergy between language access improvements, leadership commitment, technology innovations, and targeted funding that can accelerate language access improvements. If you are interested in presenting on language services, cultural competence, or other components of creating equitable health systems, submit a Call for Proposals to Diversity Rx by February 1, 2010. Next year’s Diversity Rx conference will be held October 18-21, 2010 in Baltimore.

Contact: Erin Bowman

Dr. Glenn Steele Presents at CAPH Annual Conference

Glenn Steele, MD, CEO of Geisinger Health System, provided a keynote address at the CAPH Annual Conference on Dec. 4 in Monterey. Dr. Steele’s presentation outlined the steps his organization has taken to create coordinated, patient-centered care and offered insight into the key elements that are necessary to provide seamless care. Geisinger Health System was recently featured in Time Magazine for its ability to provide care that is not only high quality, but also cost-effective and coordinated. President Obama has also commended the innovative work being done by Dr. Steele and his colleagues at Geisinger. To view Dr. Steele’s presentation, visit the CAPH website.

New Initiative Aims to Improve Patient Safety in Public Hospitals Nationwide

Kaiser Permanente (KP), along with the National Association of Public Hospitals and Health Systems (NAPH) and the National Patient Safety Foundation (NPSF), have launched the "Patient Safety Initiative at America's Public Hospitals," a two-year program aimed at boosting patient safety in 85 public hospital systems nationwide. Forty-two hospitals have been selected for Phase I in 2009. The application process for public hospitals interested in the second phase of the Initiative, to begin in July 2010, will be opened sometime in early 2010. Six CAPH-member hospitals are participating in the first phase of the project: Arrowhead Regional Medical Center, Contra Costa Regional Medical Center, Kern Medical Center, LAC+USC Healthcare Network, San Francisco General Hospital, and Santa Clara Valley Medical Center. The program will assist public hospitals in adopting innovative patient safety and quality care programs and will establish a shared set of patient safety tools and techniques For more information, please contact Brigette Scott at (202) 585-0102, Lorna Fernandes at (510) 271-5624, or David Coletta at (617) 391-9908.

Public Hospitals Featured at The California E-Prescribing Consortium 2nd Annual Meeting

Kern and San Mateo Medical Centers presented best practices and lessons learned from their recent electronic prescribing implementation to a statewide stakeholder audience at the 2nd annual meeting of the California e-Prescribing Consortium, CALeRX.CALeRX’s vision is the promotion of e-prescribing (eRx) as part of an electronic health record as the standard of care. San Mateo’s presentation focused on the technical issues encountered during product testing and how to support staff with work flow transitions during the go-live phase. Kern discussed the importance of implementing e-RX in their system from the perspective of improving patient safety and providing their clinicians with efficient and current technology for managing prescriptions. For more information, visit the CALeRX website.

New Funding Opportunity from the Office of the National Coordinator (ONC)

The ONC for Health Information Technology announced a new $235 million initiative, the Beacon Community Program, for 15 “Beacon Communities” to leverage their existing electronic health records (EHRs), health information exchange (HIE) capabilities, and expertise to achieve measurable improvements in health care quality, safety, efficiency, and population health. Applicants must represent geographic regions with very high (25-30%) EHR adoption rates, and be national leaders in the advancement of health IT, workflow redesign and care coordination, or quality monitoring and feedback, and must demonstrate either:

1. existing, advanced infrastructure for health IT and exchange; or

2. previous success and/or advanced core-competencies in community-level practice redesign, care coordination, community-level evaluation, or performance monitoring and feedback.

Letters of intent are due January 8, 2010, with applications due February 1st. For more information and instructions on how to apply, click here.

Upcoming Events and Deadlines

  • January 20, 2010: SNI’s e-Prescribing Pilot Final Program Convening will be held from 10:00 am to 3:00 pm at The California Endowment, Oakland office. Contact: Mary Gregory.

  • February 4, 2010: FREE Conference on Addressing Cost Efficiency in Healthcare: Reducing Inappropriate Use of Emergency Department, from 9:00 am to 3:30 pm in Los Angeles. Contact: Giovanna Giuliani at (415) 615-6377.

  • February 18, 2010: Lean Core Measures Initiative Final Review and Part II of the Summit to Accelerate Operational Efficiency to be held in Oakland. Contact: Angelina Ramos at (510) 874-7102.

  • March 18-20, 2010: SNI will co-sponsor the conference Healthcare Interpreting: From Face-to-Face to Cyberspace, which will be held at the Westin South Coast Plaza Hotel in Orange County. Contact: Beverly Treumann.

  • Tune in “live” to IHI’s WIHI free “talk show” series. IHI Scholarships are also available for various 2010 IHI programs now. Contact: Angelina Ramos at (510) 874-7102.