If you want to go far, go together: Contra Costa Safety Net Summit

If you want to go fast, go alone. If you want to go far, go together.
~Contra Costa Safety Net Summit, April 2011

What a great day of collective thinking and learning with an amazing group of people. I spent the day the Contra Costa Safety Net Summit which brought together stakeholders from across the safety net.

Jeff Kutash gave a thought provoking presentation on Collective Impact to drive large-scale social sector change. He presented fascinating examples from across the world ranging from the juvenile justice system to Strive, which is increasing high school graduation rates- reading and math scores and increasing the number of children in preschool to prepare for kindergarten. One example illustrated a community solution related to poverty. Farmers had a fixed amount of space and they could grow a fixed number of crop. By focusing on development of a better seed they were able to grow four times the crop in the same space. Farmers now earned four times the money. The community now had four times the resource. At one point it was suggested that a new system is within reach of safety net leaders. He summarized by noting that this sort of change requires the "usual suspects to work in unusual ways" - that's us!
He noted that in each example of collective success there were five conditions found:
1. common agenda
2. shared measurement
3. mutually reinforcing activities
4. continuous communication
5. backbone support organization

The picture below provides an illustration of his talk. I have to add here that Emily Shepard did such a great job capturing the day in picture and summaries. Click on the picture for a closer view.

I loved the map on the wall. We placed ourselves on the map. I learned a great deal by being able to see what the safety net looks like from this perpective. To my delight and surprise, I also found Matt Steifel from Kaiser (and a fellow IHI Fellow)at the map!

Wanda Session and Patricia Tanquary

The group identified gaps in the safety net as well as strengths.

The group set out some next steps, one of which will be forming a time-limited task force made up of cross sector representatives. The day closed with Supervisor John Gioia who grounded us in reality with the sobering facts and figures we all know too well. Health is not being experienced equally in our county. We know because it is our mission and our promise to leave no one out. We are dedicated to caring for all in our community with special attention to those most vulnerable to health conditions.

Supervisor Gioia closed with a quote from our 38th Vice President, Hubert Humphrey.

It was once said that the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped.
Hubert H. Humphrey

Perinatal Report Out today in the CCRMC lobby at 10:00 am

In "Healthy People 2020" released in December of 2010, the U.S. Department of Health and Human Services released the new 10-year goals for our nation's health - and supporting breast-feeding is prominent among them. By 2020, the goals call for increasing the percentage of Baby Friendly Hospitals to 8%. Contra Costa Health Services is committed to providing quality patient-centered care.

As a review, in October 2010 a team of physicians, nurses and social workers from the medical center, health centers, Healthy Start and public health performed approximately 50 patient observations and time studies of the patient experience from the prenatal visits, through delivery and ending with the first post partum visit. From these observations, the team created a current state map of what our patients experience during their care across the entire care experience. The current state was critically evaluated to determine a vision of our future state.

Please join us this morning in the CCRMC lobby at 10:00 am to learn more about the work of your colleagues and our patient and family partners as they draw on science and the energy and creativity of each other to continuously improve our health system.

Anna

HHS Region IX Launch of Partnership for Patients at Contra Costa Regional Medical Center

Dear Contra Costa Regional Medical and Health Center Community and our valued partners:

Thank you all for joining us today for the Region IX launch of the Obama Administration new initiative, Partnership for Patients. I was honored to introduce our organization and our accomplishments to our local, regional and national leaders. As a public hospital, we play a critical role in our community’s health and we are proud to join hospitals across the nation pledging to improve care and save lives. Here is the Contra Costa Times story that highlights the event.

It is an honor to pledge our support for this ambitious new intiative and to have our achivements recognized by our nations leaders.
Speakers included:

Congressman George Miller,7th District of California
Herb K. Schultz, Regional Director, HHS, Region IX,
David Sayen, CMS Regional Administrator, HHS, and
Joseph McCannon, Senior Advisor, Centers for Medicare & Medicaid Services, HHS

We were joined by consumers, industry representatives, and other key health care stakeholders to highlight the historic reforms of the Affordable Care Act. The new initiative, Partnership for Patients, will help save 60,000 lives by stopping millions of preventable injuries and complications in patient care over the next three years, improving quality and containing costs.

Already, more than 1300 hospitals, as well as physicians and nurses groups, consumer groups, and employers have pledged their commitment to the new initiative.

Our commitment to patient safety has been longstanding. As the people who are working on behalf of our community to continually improve our great health system, you should be proud of the work and the many milestones achieved at Contra Costa Regional Medical Center.

Above are just a few examples of what we have accomplished. You can find them posted on the walls of your work areas. Your achievements are many. You have opened doors that were once closed and welcomed in patients and family members as part of your teams. You have learned to have meaning discussions and shared-decision making with out partners. You have embraced the science of improvement and you are making a difference.

As science and our knowledge of how to create sustainable change continues to advance, we now know we can achieve results that were once thought to be - by hospitals nationwide - out of our reach.

It’s time to challenge ourselves. We can do more.

This isn't an easy conversation for health care providers to have. We go into healthcare to help and heal those in need. It can be difficult to talk about being part of, as Joe McCannon so poignantly stated, a health care system across our nation that is "rife with waste, harm and in urgent need of improvement." Even though this is difficult, we can’t let that deter us. The time has come. The conversation must take place and the Partnership for Patients offers the opportunity to have that dialogue.

At Contra Costa Regional Medical Center and Health Centers we will:
• decrease by 40%, preventable hospital-acquired conditions by the end of 2013
• reduce by 20% hospital readmissions by the end of 2013.

We will look to science and to our partners. Along with others across our region and our nation we will design systems of care that provide the care that our communities want need and deserve free of preventable complications.

U.S. Department of Health and Human Services, Partnership for Patients: To Improve Care and Lower Costs, Regional Launch at CCRMC Friday, April 22 at 10am

Greetings-

I am excited to extend an invitation to you to the regional launch of the U.S. Department of Health and Human Services' Partnership for Patients: To Improve Care and Lower Costs Initiative to be held at CCRMC this Friday April, 22 at 10am. As you know, CCRMC has had a longstanding commitment to providing the highest quality care to those we serve. We are deeply honored to be chosen as the host for the regional launch of this national collaboration. I hope you can join us.

Please feel free to contact my office directly if you have any questions.

Sincerely,
Anna

Lean(ing) into it: Update on Budget, Sustainability Study and Redesign

I will be joining the Improvement Academy tomorrow, Thursday April 14th, to provide an organizational update on the following:

1. Budget hearings and process
2. 1115 Waiver/ Delivery System Reform Incentive Pool (DSRIP)
3. Planned upcoming leadership changes and next steps at CCRMC and CCHC's
4. Our commitment to the "Partnership for patients to improve care and lower costs for Americans"

Noon conference phone lines will be open

Anna

Did you know that 1 in 10 Americans are trying to eat on $1 per meal?

Food Stamped: May 5th at CCRMChttp://www.foodstamped.com/

Join us in the Contra Costa Regional Medical Center lobby on May 5th at 6:00 pm for a screening of the new documentary, “Food Stamped.” The film follows a nutrition educator in low-income neighborhoods and her filmmaker husband as they attempt to eat a healthy, well-balanced diet on a food stamp budget. We will be joined by the director of the film, Yoav Potash, as food justice advocates, nutrition experts, politicians, and people living on food stamps share there perspectives on the struggles low-income Americans face every day. You can learn more by going to the Food Stamped website here.

I hope you will consider joining us for this very important screening. A panel discussion to directly follow.

Panelists:
Yoav Potash, Film Director, Food Stamped
Anna Roth, CEO, CCRMC and CCHC
William Walker MD, Director, CCHS
Alan Seigal MD, CCRMC and CCHC
Tracy Rattray, Director of Community Wellness and Prevention Program

When the student is ready, the teacher will (re)appear

Posted by guest blogger, Charles Saldanha MD

“When the student is ready, the teacher will (re)appear”
-variation on a Buddhist proverb

Just prior to starting internship, my classmates and I received a gift. It was a book called Through the Patient’s Eyes: Understanding and Promoting Patient Centered Care. I regarded it as a kind token intended to remind us, as we filled our heads with scientific and technical knowledge over the years upcoming, that patients came first. That’s what we’re about as physicians, right? I didn’t read it. I had plenty else to read and not enough time to sleep. Making sure that I was “up to date” felt far more important and urgent.

In subsequent years, the book found a cozy home on bookshelves in various apartments, homes, and offices. It made three cross country trips. In the meantime, I was trying on different professional hats, unconsciously seeking to reconcile diverse and at times divergent ideas of what it means to be a physician.

On a weekend morning a few months ago, the spine caught my eye as I sat in our living room. I extracted it from between old textbooks and paperbacks and opened it. The binding cracked like a new book. I smiled to find that the contents I dismissed as so obvious and straightforward as to not warrant reading, I now recognized as addressing the most fundamental and challenging parts of our work.

Today, we apply more scientific knowledge, technology, and financial resources toward restoring health than any other civilization has at any time in human history. Yet, even with this relative embarrassment of riches, we struggle and all too often fall short of providing the health care that patients want and deserve. The challenge of our time is harnessing resources and scientific advance in a way that moves health care forward, principally from the perspective of the patient. Our patients and their loved ones have need us to recognize the situation and take it seriously; certainly, the crisis is immediate and real for those we serve.

Like unread books, the people who come to us for care are waiting to be asked for their knowledge and guidance. We need to have the humility to invite them and courage to overcome mistrust and check our professional pedantry at the door. By opening and sustaining that conversation we can become who our patients need us to be.

Charles Saldanha MD