Wednesday, May 29, 2013

Ambulatory Care Redesign Rapid Improvment Event (Kaizen): Referrals

Last week a team of four Care Coordinators, a Clinic Coordinator, a Provider, and one of our patient partners, Amanda, came together to work on our external referral process. This process starts when a provider initiates a referral for a clinical need outside of our eight health centers and ends when results have been received from the organization where the patient was seen. Referrals for services outside of our system have the potential to be highly complex with multiple hand-offs.

As an organization we are in pursuit of a patient-centered referral process that is free of defects and unneeded waits. To reach this future state the team is developing a process for tracking and coordinating all external referrals. This referral process is an integral piece of constructing our health homes in Contra Costa. The process is being tested and refined in the Martinez Health Center with a plan to spread it in the coming months. If you want to learn more please feel free to contact the Lean Promotion Office. Thanks to all who joined one of the report out presentations. For those who were unable to make it, I have included the slides above. 

More very soon, 

Thursday, May 23, 2013

Toward Health Reform: Contra Costa Health Plan selected to participate in state insurance exchange

California took an historic step toward realizing Health Care Reform today with the announcement of the 13 health plans that will participate in the state’s health benefit exchange. I am very pleased our Contra Costa Health Plan is among the plans that will be offered through Covered California.

As part of our integrated health system, Contra Costa Health Services, CCHP has a long history of serving Contra Costa County residents through its extensive county and community contracted provider networks. Our Regional Medical Center and Health Centers (CCRMC) will see some of those new patients and many also will be cared for through CCHP’s many contracted providers, community clinics and hospitals throughout the community.

Participation in the exchange provides CCHP the opportunity to continue and expand its long legacy of ensuring the community has health care coverage. CCHP was the first county-sponsored health plan in the nation to receive federal qualification and to offer Medicare. I think it's fitting that as CCHP celebrates it's 40th year in operation it continues to play an important part in advancing access to care. Today, CCHP provides coverage to 120,000 people, including county employees, small and large business groups, seniors, people with disabilities, children and low-income patients. We are proud our health plan is playing a vital role in this exciting transformation of health care in California.

CCRMC and HCs Rapid Improvement Event (Kaizen) Report-Outs tomorrow

The Update: Getting the Word Out - CCRMC and HCs Monthly News

Getting the Word Out
As someone who oversees a dynamic health organization, I’m always looking for ways to better communicate with people about what we’re doing. That’s why I’m so excited about the new Contra Costa Regional Medical Center (CCRMC) and Health Centers' newsletter, The Update. Find the most recent issue of The Update here. My goal is that this newsletter will serve as a vehicle to showcase the great work being done by our staff, and help keep our delivery system connected and up-to-date on the many ongoing projects we have underway to transform our health system in this new era.
The most recent issue of The Update highlights many exciting things going on at CCRMC & HCs including a successful effort to reduce hospital associated pressure ulcers, how the Pediatric Response Team’s prepares for pediatric emergencies, and a new program in which our Cancer Center is offering iPads to patients to use during their treatments.
If you’d like to keep up with the happening at our hospital and health centers, I encourage you to click the button below to join the mailing list for The Update.

More very soon,

Friday, May 3, 2013

Where Does Change Begin? Why we (you and I) must not settle.

It was only a few years ago that there were no red lines on the wall behind the beds in CCU –anyone providing patient care could only guess at what 30 degrees looked like. What was a Bundle? We couldn’t go for months without a Ventilator Associated Pneumonia (VAP). When I reflect on it now, it almost seems we planned care knowing that assisted breathing was inevitably, or at least understandably, going to be accompanied by pneumonia. It was hardly imaginable that we could go months without a VAP. Now VAPs and many other serious hospital-associated infections/complications are rare because of the innovative work of our staff. When I was initially trained as a nurse – not the formal school-based training but the ward/unit training which was something different altogether – I was taught that our 'rapid response,' commonly known as a Code Blue, was a team of highly skilled clinicians that rushed to a patient in need of respiratory or cardiac rescue/resuscitation. Today we have rapid response teams (Medical Emergency Teams, RRTs, etc.) that quickly bring additional needed assessment and care to patients when they first exhibit signs that may signal a dangerous decline in health – in most cases before a Code Blue.

Thankfully, things are changing here and everywhere. I find strength and inspiration in the stories from the bedside of those who are committed to improving health care. We are increasingly recognizing and embracing the fact that the use of improvement science does improve health and does so in dramatic and revolutionary ways. Our monthly Rapid Improvements Events are example of the ongoing improvement work in our delivery system.

As promised, here are the slides from last week’s Rapid Improvement Event (Kaizen) on the medication refill process. Many thanks to the staff from the front line and Patient and Family Partners who are working hard to improve our system for everyone. Your efforts are greatly appreciated. I also want to thank our team members who came out to support these teams. Improvement is hard work and your support is crucial.

Refusing to Settle

In spite of all the results seen here and around the world, why is it that improvement, led by front line staff, patients and family members continues to feel as though it is regarded as a "soft" or support activity? Improvement is about the work of saving lives.

We must be committed to driving defects and non-value-added activity out of what we do. I will stand with all of you, who are dedicated to serving our community and improving our system, to continue to focus on and pursue our mission.

George Halvorson in his book Health Care Will Not Reform Itself, states "the alternative to courage and focused action is a continuation and probably a worsening of the status quo." Many will agree that it takes acceptance, willingness, courage, caring and honest exchange to engage in a change effort. It also takes constancy of purpose and discipline.

There are many distractions along the path to an improved and sustainable system. The inertia of the status quo and pervasive nature of the health care industry's hierarchical culture can seem impossibly strong. Many have mastered the current state; their power, position and self-image may be derived from that mastery. Many believe that more of the same is good enough. I believe that to seek a new order, to resist the urge to 'settle,' to stand up and lead a transformation effort, is indeed the work of the courageous. It is our work. It is work we must do together. However, the first step is to change ourselves - which may be the most difficult step of all. Many will settle, taking refuge in the status quo. I will not.

What will you do?

More very soon,