Saving Our Caregiver Workforce with Dialectical Behavior Therapy (DBT) Interventions

In 2021, direct care staff turnover in our agency was close to 35%. We are a treatment foster family agency and residential therapeutic program for youth and families impacted by the child welfare and juvenile justice systems. In a field where stability and consistency of healthy relationships is vital to the success of our clients, this was a crisis.

Vietnamese American Service Center

Imagine an under-resourced place in East San Jose where Vietnamese immigrants live with significant health and social disparities. The community is painfully aware that due to legacy of war, political persecution, and mass displacement, they have been through significant multigenerational trauma. They prioritized and advocated for the building of a trusted place where they can receive mental health services in their own language or through an interpreter that they trust.

Bringing Accompaniment to Inpatient Clinical Spaces: The Creation of a Health Advocate Program for Black Inpatients at UCSF Health

Nationwide, Black patients who are admitted to the hospital experience disparities in pain management, patient communication, length of stay, and readmission rates. This disparity is seen at UCSF Health, where black inpatients have lower patient communication scores, higher lengths of stay in the hospital, and higher readmission rates than the rest of the patient population. In addition, there is limited engagement and input from community members in the care that hospitalized patients receive at UCSF Health.

Maximizing 340B Revenue

Central City Community Health Center, Inc. is a federally qualified health center that relies on 340B savings to supplement our care to the uninsured and underinsured communities we serve. Unfortunately, our 340B program has never been optimized to fully realize the full benefits of the program. In 2021, we were experiencing multiple organizational barriers including lack of 340B program awareness among our staff, not capturing savings from providers we refer our patients to, and many missed opportunities that led to potentially millions of dollars being left on the table.

Optimizing Safety-Net Primary Care Access in the Era of COVID-19

Primary care practices in the safety-net face increasing demands for services as the COVID-19 pandemic has elevated health awareness and state initiatives continue to expand Medi-Cal coverage. At Los Angeles General Medical Center (LA General), the largest primary care site within the Los Angeles County Department of Health Services (DHS), we noted that the years of deferred care, rapid primary care panel growth, and marked workforce attrition pushed our clinics to the breaking point.

Building Organizational Excellence Within Olive View’s Hospital Operational Leadership Team.

When thinking about organizational excellence within a health care organization, clinical efficiency and quality patient care immediately come to mind. Physicians and nurses who provide direct patient care take center stage. What about the radiology and lab staff whose images and test results ensure appropriate diagnoses? What about the schedulers that support patient access, the housekeepers that keep the environment clean for safe patient care, and the facilities management tradesmen who work to keep the lights on?

Getting to the Heart of Behavioral Health Quality: A Measurement Based Care Quality Improvement Program (QIP)

The overall purpose of this CHIP was to implement a measurement-based care (MBC) program, utilizing four validated assessment tools: the PHQ-9 (depression), GAD-7 (anxiety), ACEs (trauma), and BAM-7 (addiction and social determinants of health). This program had two phases: (1) establishing a common data collection platform across a diverse range of (largely rural) behavioral health providers, and (2) providing targeted clinical summaries and connection to educational opportunities for clinicians participating in this program.

Inpatient University: Empowering seamlessly

Often, education of our hospitalized patients occurs in the last few hours of their stay. And there are no standards for how to perform this critical work. This project was inspired by my Spanish-speaking patient, Jose. Jose was re-admitted to our hospital with cirrhosis and volume overload, a new diagnosis that was made just a few months prior to when I cared for him. In exploring what happened, he barely recognized the term “cirrhosis” let alone Lasix and the other medications that were prescribed to control his symptoms.

Implementing CalAIM Community Supports to Create a System of Safe Discharge Options for Challenging Patients from Acute Care Facilities to Decrease Administrative and Denied Days

Medicaid patients remain in acute care settings (acute hospitals, long term acute care hospitals, skilled nursing facilities) because there are no safe, clinically appropriate discharge options. This results in an increased number of administrative or denied days because the patients are no longer clinically acute and are just awaiting placement. Patients who could be in an inpatient bed or in a skilled nursing facility are instead stuck boarding in the emergency department or an inpatient bed.

COVID-19 Data to Action: From Bean-Counting to Beanstalk-Climbing

The COVID-19 pandemic illuminated longstanding vulnerabilities in public health disease response, lab reporting, technology, and our workforce capacity to address a surge in a novel respiratory virus. Prior to COVID, I had gained extensive experience leading data-driven HIV and STD programs in San Francisco and collaborating across siloes improve population health outcomes.