Thursday, June 28, 2012

Health Care for All

                                                                     Photo source:

Health Care for All

I’m guessing I was not the only one who was moved this morning when the Supreme Court ruled in favor of the people instead of politics (actually, I know I wasn’t!). I'm grateful that our nation has taken another step toward no longer tolerating the suffering and inequities brought on by a broken health care system.

I have spent my entire career working in the safety net, serving people who are either uninsured or underinsured and have witnessed with frustration how we’ve failed as a nation to care adequately for those most in need. But today’s court decision brings us ever closer to a nation where everyone has access to the health care they need and deserve.

Though today is a time for celebration, there is as much work and challenge ahead as there is opportunity. The court’s decision could allow states the choice to participate in the Affordable Care Act’s (ACA) expansion of Medicaid coverage. The ability to “opt out” of Medicaid expansion could leave many of our nation’s most vulnerable people without access to health care. It’s important to recognize where we are in this movement toward a reformed health care system. Washington has once again stepped forward and preserved the possibility of a nation where the promise of health is equally distributed. Now it’s our turn to renew our efforts to improve the patient experience of care (including quality and satisfaction); improve the health of the populations; and reduce the cost of health care. 

We have already taken many important steps in health reform. We are expanding health coverage through our Contra Costa Health Plan. We have improvement efforts under way across our delivery system. Together, in partnership with those we serve, we provide quality care to all people in Contra Costa County with special attention to those who are most vulnerable to health problems. We continue to meet our responsibility to engage as active members of America’s Health Care Safety Net and as participants in the nation’s movement toward reformed health care.

It's true that we have many challenges before us. Yet I don't see the imperative to reform our health system as a burden, but rather a privilege. It's the commitment to service, and the skill and spirit I encounter every day working on the Contra Costa team that has convinced me beyond any doubt that no matter what lies ahead, health care for all is within our reach.

More very soon,

Wednesday, June 20, 2012

What Summer Vacation? Remembering to Breathe and Flash Mobs

We couldn’t be in a more stressful environment than right now. That is the sentiment being expressed all around me. We’re less than two weeks away from “go live” of our electronic health record, ccLink, opening of our new West County Health Center this summer, expanding the Concord Health Center, developing the patient-centered health-home model and continuing ongoing improvement efforts as we help make health reform a reality (see my April 29 post). Any one of these alone would be enough to stretch us to capacity!

The Contra Costa team continues to model effective and simple ways to harness the winds of change and drive forward. Exercise and healthy eating are within everyone’s reach. You can start small by replacing an elevator ride with the stairs or taking a stroll to the Farmers Market at the CCRMC campus every Tuesday to browse the fresh food choices. In the coming weeks, I will introduce our planned efforts promote movement and physical activity in our county.

Perhaps an even more simple way to promote well-being and something you don’t have to go anywhere for is remembering to just breathe. Our employee’s creativity never ceases to amaze me (it’s one of the reasons I love working here). Karen Lloyd, one of our Rehab Therapy Services managers, provided a short demonstration last week to our leadership team focusing on mindfulness and breathing to reduce stress and help increase focus. After less than a minute of closing my eyes and concentrating on my breathing, my stress level plummeted as did our collective blood pressure I imagine. This small practice is based on Jon Kabat-Zinn’s Mindfulness Based Stress Reduction (MBSR) – an evidence-based process piloted at the University of Massachusetts Medical School to promote stress reduction for medical professionals and patients. This exercise is a regular feature of the Wellness Groups offered within our system in the Integrated Health Services program led by Dr. Karen Burt and Dr. Joyce Tang. It has been shown to reduce stress, depression and anxiety and even improve performance. I’ve heard rumor that mini mindfulness Flash Mobs (yes, I said Flash Mobs!) are springing up throughout the system, so keep an eye out for the opportunity to just breathe.

For those who may not be familiar with the term "Flash Mob," I leave you with a short video of one of the most frequently viewed Flash Mobs on the web. Enjoy...

More very soon.

Monday, June 18, 2012

Breaking Eggs (or not?): NAPH Fellows Visit Contra Costa Regional Medical Center

CCRMC had the honor today of hosting the this year’s National Association of Public Hospital and Health Systems (NAPH), fellows. It was exciting to meet leaders from across the country embarking on a journey I took myself just a few years ago. The visit was part of the fellows learning session which coincides with the NAPH annual conference, which starts Wednesday in San Francisco.

Our Health Services Director Dr. William Walker and I had the privilege to share our organization's story and to talk about some of the accomplishments here at Contra Costa Regional Medical Center and Health Centers. We started the day in our Redwood Grove and then the fellows were given a tour of our hospital in areas that have been the focus of some of our improvement efforts.

Patient and Family Member Partners shared their stories and our staff shared lessons we have learned in the application of the Model for Improvement and Lean management. Our guests had a chance to participate in interactive exercises designed to illustrate how Lean and rapid improvement works. I was struck by the creativity of the different groups when designing. One of my favorite parts of the day was watching the imaginative design concepts that teams came up with to protect an egg from breaking when dropped several feet from a ladder!

It was reinvigorating to spend time with the NAPH fellows. Today was yet another reminder of how truly important and essential the improvement work you are all doing is. I look forward to presenting on patient and family involvement this Thursday at the NAPH conference and am excited to hear what other systems are tackling so stay tuned.

More very soon.