Sunday, April 29, 2012

The Power of Purpose

Act as if what you do makes a difference. It does.  ~William James
It’s easy to understand, even predictable really, how we can get distracted by the sheer volume of projects underway in our system. What’s happening in and around our system is huge. In addition to our ccLink electronic health record implementation, we’re opening the new West County Health Center this year, expanding the Concord Health Center, continuing our improvement efforts and working on a multitude of other projects to fully realize Health Care Reform in our county.

So how do we, as an organization undergoing so much change and transformation, not lose focus and get swept away by the business of operating, updating and upgrading? I’ve felt myself being pulled into the swirl of the technological advances we’re implementing, as well as the many new exciting opportunities to improve ourselves, such as the 1115 Waiver and Delivery System Reform Incentive Payments (DSRIP) program. I want to take a moment to pause amid this organized commotion and revisit the real reason we are undertaking these monumental projects. I remind myself that these are all just tools, means to an end, to help us fulfill our purpose: to care for patients. 

There are many demands for our attention and time. Make no mistake that these efforts to improve our system are critical to realizing our mission. We are now more able than ever to provide care on a larger scale and in better ways than we ever thought possible.  But even while we are well into our ccLink implementation and other improvement and innovation, we need to keep our focus on our mission to serve.

The efforts we are making toward quality and safety improvement, patient-centered care/partnering with patients and families, and other innovations are essential. When given the opportunity to step back to scan the entire landscape of what is underway, it’s truly breathtaking to see all that we are working on. Never a week goes by that I am not asked about the innovative work you are all doing - that includes you, our patient and family partners! When I speak at events, unfailingly I am approached afterward by organizations praising your work and wanting to learn more. I think it’s because we are bold enough to try new and creative approaches with patients and family members as partners to find novel ways to do “common things uncommonly well.” What does this mean to me? It means that our system is being redesigned to provide the best and highest quality care that results in a superior care experience and an overall better health status for Contra Costans while doing so at the lowest possible cost. 

The work we do requires inspiration, and I find that remembering to refocus my attention on why I’m doing this work is crucial. Fortunately, there are many sources of inspiration right here in our own system and elsewhere. I’m currently reading “Privileged Presence: Personal Stories of Connections in Health care” by Liz Crocker and Bev Johnson. In their book, patients, family members and caregivers share their personal experiences. It’s a powerful reminder of the need for compassion and humility among those of us who work in health care. I’ve shared this book with my leadership team and the stories that many of you have shared with me and others, the resulting discussions have been reinvigorating.

If we can remain focused on our goal—to provide the best care possible for those most in need—we won’t lose track of our mission. Otherwise, the ones who will lose will be the very people we have pledged to help. Please join me in keeping a razor sharp focus on our purpose, the purpose of ccLink, DSRIP, innovation, improvement and all we do: providing the best care in the best way to those we serve.


Saturday, April 28, 2012

Education is Powerful Medicine: CCRMC Seamless Transitions Kaizen Report-Out

 The Report-Out was great. Congratulations to the team, which included providers and patients working to create seamless transitions in care. The group broke into three smaller teams that focused on important areas of opportunity to improve transitions in care. Working with front line providers and patients ideas were tested.

     Problem: Staff don’t know what education has already been given
      Prioritization Process
     Problem: No education focus or priority
     Problem: Majority of education given 10 minutes before discharge

It was great to see the human factors design embedded in the interventions. Teams focused on the development and testing of standard work. I noticed two new checklists- see the slides above. I was also pleased to see that in addition to clearly designing around the patients,  there was also a clear focus on measurement!

Many thanks to the team and to all who came out to hear the results from this weeks Kaizen.


Thursday, April 26, 2012

We're now approaching the halfway mark on our schedule of ccLink Road Shows and what a success it has been! From Richmond to Brentwood, staff have come with a great deal of interest and are eager to learn about this exciting project. As you learn about the system, we too are learning more about your needs and what ccLink will mean for your day to day activities.

Everyone had great questions and provided important feedback. If you had a question that couldn't be answered during the Road Show, it might have been answered in our latest FAQ. Didn't have time to ask your question? Submit it on iSITE or send an email to

We still have seven Road Shows to go. If you've missed the one at your worksite, check our schedule to see if you can attend one at another location. Make sure you regularly visit the ccLink page on iSITE for the latest updates and a wealth of information.

- Friday, April 27: Pittsburg Health Center
- Monday, April 30: Martinez Health Center, Building 1 Conference Room
- Monday, April 30: 7:30 a.m. and 3:30 p.m. Contra Costa Regional Medical Center
- Wednesday, May 2: 8 a.m. Juvenile Hall and 3:30 p.m. West County Detention Facility
- Thursday, May 3: 3:30 p.m. Martinez Detention Facility

More very soon.

We're heading out into the system to update staff about the implementation of ccLink, our electronic health record system (EHR).  

The updates are going well. There has been a great deal of interest and participation at the health centers. I want to thank everyone who has come to learn more about ccLink. Your questions and comments have been extremely valuable and are generating rich learning and discussion.
All the Health Center meetings will run 12:15 p.m. to 1 p.m.

Today we will be at the Concord Health Center.

More very soon.

CCRMC and HC are improving transitions in care. Kaizen Report Outs are this Friday at Richmond, Pittsburg and CCRMC.

Sunday, April 22, 2012

CCRMC and HC Seamless Care Transitions Rapid Improvement/Kaizen One begins Monday, April 23

This week will be the first Rapid Improvement/ Kaizen event for Transitions in Care from Hospital to Clinics on April 23rd to April 27th. The location for the work will be at our Contra Costa Regional Medical Center.

As background, on March 26th, a multidisciplinary team came together and conducted an in-depth analysis (value stream mapping) of the transition periods that patients experience going through a hospitalization. This involved looking at the entire experience of care.  The team began examining the care experience from the time a decision was made to admit a person in the ER, through the hospitalization, and then to the first follow-up appointment after discharge. Based on their observations, they were able to build a current state map that displayed the steps in the process. After reviewing these steps and assigning value - from a patient’s perspective (this is key) - the team developed a future state map that, while nested in science, embodies what patients want the process to look like within the next twelve months. Lastly, a Team Charter, also known as an A3-T, was developed to provide a detailed summary of our target metrics, proposed actions, and the sequence of Kaizen events that would help improve the process. Here are the slides from last report out. 
CCRMC and HC Seamless Care Transitions March 30, 2012
During this Rapid Improvement/Kaizen event the team will be focusing on patient education and communication during a hospitalization. The team, which is made up of front line providers and patients, will refine the education delivery that we provide to patients and establish a structure for accountability. During the value- stream- mapping observations it was common for the majority of patient education to happen during admission and discharge.  One of the aims of this week is to standardize the pace at which information is provided to patients. The team will also address education prioritization. Specifically the team hopes to create a system that produces shared understanding of where to concentrate education efforts. What we hope to produce is a system that reliably delivers the information that people need and want. I’m looking forward to the innovative ideas that I know the team will test during the week as they work to improve experience of care in our health system.
Kickoff and open-to-all learning session is tomorrow, MONDAYApril 23, at CCRMC 11:00 AM- 1:00 PM
The Rapid Improvement Event (Kaizen) Reports are FRIDAY, April 27th at:
  • 7:45-8:15 AM - Richmond Health Center Lobby
  • 10-10:30 AM - CCRMC Hospital Lobby
  • 12:15 - 12:45 PM - Pittsburg Health Center Lobby
More very soon...

Friday, April 20, 2012

We're heading your way: ccLink open forum "Road Shows" coming to you soon

On Monday, we’re packing up and heading out into the system to update staff about the implementation of ccLink, our electronic health record system (EHR).  

We heard loud and clear when you said you wanted information brought to you so our Leadership Team and ccLink subject matter experts will be visiting our Health Centers, the Regional Medical Center, Detention Services and other locations. It’ll be an opportunity to ask questions and learn the latest about one of the biggest and most exciting endeavors our health system has undertaken. 

All the Health Center meetings will run 12:15 p.m. to 1 p.m.

The first will be held at the Richmond Health Center on Monday, April 23.

On Tuesday, April 24, we’ll be at the Brentwood Health Center.  (See iSITE for the full schedule to be posted soon.) 

Please join us as we gear up for staff training, which starts next month, and our Go-Live date of July 1!

More very soon...

Sunday, April 1, 2012

90-Day Readiness Assessment: On track with ccLink

On Wednesday, we conducted our 90-Day Readiness Assessment with Epic and the results show we are on track to launch our electronic health record system on July 1.

As I listened to the different teams report on how they are progressing on their pieces of the ccLink implementation, I was struck again by the enormity of the project. This is not an easy task- it is taking and will continue to take enormous dedication, commitment and teamwork on everyone’s part to achieve our goal.    

I also was thrilled to see how everything is coming together and how we are steadily moving closer to making our EHR a reality. This is an exciting time as we near the home stretch. We really are in our own “Spring Training” as we gear up for staff training next month. Keep an eye out for training updates from our Chief Medical Informatics Officer, Dr. Rajiv Pramanik. (You also can find the latest information on the ccLink page on iSITE or in the newsletter.)  

We are indeed a team, and you all are helping to bring ccLink to life. The work is immense but the payoff even more so. This isn’t just about an EHR, this is about transforming health and health care. The EHR is a key and essential step in our transformation to prepare our system for tomorrow. It will help us continue to be a leader in providing the best care with the best technology. 

With the ongoing system testing and the upcoming training, we’re moving from the conceptual to reality. We’re getting our hands on ccLink and seeing what needs tweaking and improvement. The next Go-Live Readiness Assessment, our 60-Day progress report, is on May 1 so please stay tuned. The process doesn’t end on July 1 when we go live. The fine-tuning will continue for some time as we perfect our system and you’ll get the support you need along the way.  

Everyone is pulling together to achieve this, and I appreciate all your hard work, flexibility, patience and dedication.

Thank you.

More, very soon...