Message from the Executive Director

In reflecting on the accomplishments and changes over the last 12 months, at SNI and in our work with California public hospital systems, I’d like to suggest one word that nicely encapsulates 2011: “Expansion.” And I don’t mean the waistline expansion that inevitably accompanies the holidays! With expanded funding to SNI by the CAPH membership and our foundation partners, we expanded our staff and programs to more robustly support the delivery system transformation that public hospitals are implementing under the 1115 Medicaid Waiver and in preparation for health reform. With nearly double the staff, SNI has expanded its offerings to include initiatives to enhance patient experience, reduce hospital-acquired infections, spread medical homes, build capacity for performance improvement, and foster innovation. Each of these initiatives expands efforts to carry out the Triple Aim, by improving care and population health, strengthening the patient experience, and containing costs. I wish all of you an expansive and restful holiday season.

SNI Partners with SFGH/UCSF Center for Vulnerable Populations to Design an SNI Innovations Exchange; Needs Assessment Underway

Quality health care that expands access, attracts patients, and lowers the cost of care is critical in this new era of health reform. To strive towards this goal, California public hospital systems are undertaking major delivery system transformation at a scale and pace that requires the capacity for continuous innovation.Given this need, SNI is laying the groundwork for a new Innovations Exchange for public hospital systems in California, in collaboration with the UCSF Center for Vulnerable Populations at SFGH. The long-term goal is to build a pathway for identifying, testing, packaging, and diffusing innovations among California public hospital systems, and beyond.

To kick off the development of the Innovations Exchange, we are conducting a needs assessment to understand the current and future role of innovation in public hospital systems. Through early 2012, Courtney Lyles, PhD, research specialist, will be conducting informational interviews with CAPH members and external organizations and experts. In order to become involved in this initiative or to learn more, please email Courtney.

Quality Leaders Awards Honors California’s Top Innovations for 2011

The CAPH/SNI Quality Leaders Awards (QLA) honored the best innovations taking place among public hospital systems in California at the CAPH/SNI Annual Conference on Dec. 8^th. Top Honors went to Contra Costa Regional Medical Center for their The Vaginal Birth After Cesarean Improvement Project. Honorable Mention winners included UC Davis Medical Center’s Davis 8 Medical and Surgical Oncology and Bone Marrow Transplant Inpatient Team Huddle Project, San Francisco Department of Public Health’s Community-Oriented Primary Care for their Tobacco Use Cessation: Use of Electronic Tools to Screen, Refer & Collaborate project, and Ventura County Medical Center’s Preventing Hospital-Acquired Pressure Ulcers. The Kaiser Permanente Clinical Systems Development award went to Rancho Los Amigos National Rehabilitation Center’s Improving Quality of Stroke Care in the Los Angeles County Safety Net System. Winning this year’s new QLA: Clinical Learning Award is San Francisco General Hospital’s Financial Fitness Clinic: Addressing Social Determinants for Improved Health. Congratulations to this year’s winning organizations for creating better and more effective ways to deliver the highest quality care possible to their patients. Full descriptions of the QLA program and winning entries can be found on the SNI website, along with a catalogue of all entries submitted this year.

Contact: Norma Batongbacal, (510) 874-7116

SNI’s Spreading Palliative Care in Public Hospitals Initiative Meets New Milestones of Success

Four new CAPH members were awarded palliative care implementation grants by California HealthCare Foundation (CHCF) this year and are now well on their way to developing successful and sustainable palliative care services: Harbor/UCLA Medical Center, Natividad Medical Center, San Joaquin General Hospital and Ventura County Medical Center. These four systems have joined 12 other CAPH members who already have substantial palliative care programs in place. The success of the Spreading Palliative Care in Public Hospitals Initiative - in which SNI collaborated with the California HealthCare Foundation and UCSF’s Palliative Care Leadership Center - has been remarkable. At present, palliative care services exist in 94% of California public hospitals, compared to the national average of 44% and the CAPH membership’s prior saturation of 21%.

Contact: Boris Kalanj, (510) 874-7119

Three SNI Patient Experience (PExT) Initiative Efforts Underway

The Patient Experience Transformation (PExT) Initiative consists of three support mechanisms designed to facilitate the improvement of patient experience within California’s public hospitals: The Learning Community, Action Collaborative, and CG-CAHPS Implementation Network. The PExT Learning Community provides broad-based educational support to anyone within participating public hospitals. To be included in the PExT Learning Community distribution list, please contact Program Coordinator, Rosemary Phu.

The PExT Action Collaborative is a demonstration project in which improvement teams work to rapidly transform patient and staff experience in service lines using Experience Mapping and Design, a proven methodology for transforming experience developed by SNI’s expert partner, ExperiaHealth. The following 10 participating systems are well on their way to achieving tangible experience improvements by June, 2012: Alameda County Medical Center, Contra Costa Regional Medical Center, Laguna Honda Hospital and Rehabilitation Center, Natividad Medical Center, San Francisco General Hospital, San Joaquin General Hospital, San Mateo Medical Center, Santa Clara Valley Medical Center, UC David Medical Center, and Ventura County Medical Center.

The CG-CAHPS Implementation Network works to roll out the Clinician and Group (CG) CAHPS survey in all public hospital systems participating in the 1115 Waiver Incentive Program.A workgroup consisting of CAPH members, SNI staff and national CAHPS experts developed and finalized two consensus-based documents: Recommendations for a Standardized Measurement Strategy and the Sampling Guidance, which will be used by CAPH-member hospital systems. Both documents have been uploaded on the Incentive Program (DSRIP) Portal. If you would like access to the DSRIP Portal, please contact Tramaine Lott, SNI’s Web & Communications Technology Coordinator.

Contact: Boris Kalanj, (510) 874-7119

Materials from November 18^th Quality Leaders Forum Now Available

SNI hosted its semi-annual Quality Leaders Forum (QLF) on November 18^th. Materials from that meeting may be downloaded from the SNI portal. Included are the presentation from Riverside County Regional Medical Center on surgical site infection reporting and their experience with NHSN and NSQIP, as well as updated data on CAPH-member performance on CMS processes of care measures and HCAHPS.

Contact: Seraphin Nicholson, (510) 874-7221

Health Coaching Trainings Provide Path for Effective Patient Interactions

This past fall, SNI hosted two health coaching trainings led by Dr. Tom Bodenheimer and his team from the San Francisco General Hospital/UCSF Center for Excellence in Primary Care. As public hospital clinics move towards more consistent collaborative care, there is renewed emphasis on having all members on the health care team trained to do health coaching. At the highly interactive trainings, more than 100 participants learned specific skills to guide interactions with patients, including improving listening and communications skills. While the topics covered in the trainings focused on diabetes, hypertension and hyperlipidemia, the coaching strategies covered can be applied to other chronic conditions, as well as for patient encounters during preventive and acute care.

Contact: Nermeen Iskander, (510) 874-3402

RFP Available for Using Electronic Data Standards to Communicate Laboratory Orders

The California HealthCare Foundation (CHCF) has allocated up to $300,000 to implement and test the exchange of laboratory orders using EHR-Lab Interoperability and Connectivity Specification (ELINCS) Orders. This initiative will provide technical assistance and award six to eight grants. At the end of the grant period, CHCF expects participating organizations to have fully implemented ELINCS Orders and to be delivering real-time electronic lab orders from ambulatory EHRs to lab information systems. A Request for Proposals is available now, and applications are due no later than 5:00p.m. Pacific on January 17, 2012.

Event

December 21: CIN Webinar The Patient Voice: Simple Feedback to Improve Care from 12:30-1:30p.m. Learn about the Net Promoter Score as a way to understand patient feedback and develop customer loyalty. Register here.

The SNI Bulletin is published by the California Health Care Safety Net Institute (SNI). To ensure delivery directly to your inbox please add sni_info@caph.org to your address book.

To unsubscribe, click here.