Friday, March 5, 2010

Upcoming changes at CCRMC

This communication is intended to introduce a new improvement structure for Contra Costa Regional Medical Center (CCRMC).

What is the challenge?

With an expected increase in demand for our service, we continue to strive for ways to use our vital resources in the most efficient manner while providing quality care. Our challenge is to obtain the requisite resources to meet the needs of our community. We must reliably provide evidenced-based care to promote health in our population, and we must do so in the most cost effective manner. To achieve this, we must build capacity to continuously improve our system for the better.

It is important to recognize that more is not necessarily better. This long held philosophy of our leadership is evidenced by the formation of our System Redesign Team in 2005, whose goal was to “reduce unexplained variation” in our system. We have engaged in many improvement efforts resulting in evidence-based standardization of numerous procedures. While we face many challenges, we stand on a solid history of innovation. It is with this in mind that I share with you the upcoming planned changes at CCRMC.

What is the plan?

I believe we have most of the resources that we need to transform our system. We have a caring, skilled, and talented workforce. We have a clear mission to care for the underserved. We have the support of our governing body, the Contra Costa County Board of Supervisors. What we need is to work together as a team and rethink our delivery systems.

I am delighted to announce that Lance Mageno will be assuming the role of Chief Quality Officer (CQO) for CCRMC as of March 15, 2010. As our system of health care changes to address current and future challenges, I am confident that Lance brings to this position critical skills, vision, and leadership. Lance possesses a thorough and complete knowledge of the current principles and practices of Lean Management, Continuous Quality Improvement and extensive experience in leading innovation. Lance is well respected by his peers and by all of the members of our health care team. He is well prepared to help lead our organization into the future. I expect that Lance will work vigorously with our executive team, and with the entire health system team, in order to refine and implement our strategic plan for the future.

Why a new improvement structure?

There are many remarkable examples of excellence (far too many to list) in our organization. I am proud to be associated with each of you. The magnitude of the need for services in our community is rapidly outstripping our capacity to provide excellent and safe care. Emergency Department and Crisis Stabilization visits are up. Admissions to the hospital are up. Births are up. Patients are sicker.

We are all working faster, harder, and longer, but that is not the solution. In order to deal with the multiple pressures facing our health system, we must continue to redesign our systems of care. We need to streamline our systems so that we do not have to struggle with unexplained variation, redundancy and bureaucracy in order to care for those we serve. We need to make certain that the services we offer are the services that our patients need and want. It is time to get the impediments out of the way! That is the essence of redesign and the essence of innovation.

As part of our planned changes, we will recommit to innovation and system redesign. I have asked Dr. Mitch Applegate and Marianne Bunce-Houston to concentrate their efforts on transformation and innovation at CCRMC. Working with the Safety and Performance Improvement Department, they will lead our efforts building an Innovation Council that will help adopt, adapt, implement and spread evidence-based improvements throughout our system. Both Mitch and Marianne have significant experience leading change in our system.

We are fortunate that Dr. Stuart Forman will assume the role of the Director of Critical Care Services. Stuart has worked in critical care for 17 years and has been involved in various leadership positions in the hospital. He brings a breadth of critical care skills, as well as a strong history of leading improvement efforts including the design and implementation of the Rapid Response Team and leadership of our medication safety efforts. Stuart is well prepared to assume this new role.

These are exciting and challenging times for CCRMC and for all of health care. We can and will meet our challenges now and into the future. Please join me in welcoming these changes as we prepare for the days ahead.


Anna M. Roth
Chief Executive Officer,
Contra Costa Regional Medical Center


  1. Providing innovative leadership in an industry that has long been very...well, traditional, requires constant vigilance. Particularly in times of economic stress such as these. CCRMC is fortunate to have incredible human resources. I'm looking forward to watching the new leadership unfold in these challenging times. Thanks.

  2. It’s nice to see this quote in your blog, as well as to have heard your vision for the forthcoming changes in our system. This is an exciting time for us in healthcare as well as in the history of our country. When you quoted George Washington Carver (who was most notable as an inventor, research scientist, innovator and advocate for sustainable agriculture), and then informed our group that we were seeking to be an institution with zero harm and more transparency, but we needed to understand that this would place us under more scrutiny by the public; I thought about another quote of his and that is: “ When you do the common things in life in an uncommon way, you will command the attention of the world. “ So, as we seek to make things safer and with more value for our patients, this becomes our goal as well as our challenge.
    Another quote by Carver was, “Where there is no vision, there is no hope.” It’s nice to hear the vision, because without it, we have no hope of change.

  3. I am not sure who this is, but I am assuming you were either at or heard of my comments at the Thursday Improvement Academy. It is true we need vision, yet without the skill and spirit of all of you we have no hope. It is not my vision; it is our vision, the vision of our community. Thanks so much for your comments.
    I love the quotes.