California Health Care Improvement Projects (CHIPs)

Ako Jacinto presents his CHIP

California Health Care Improvement Projects (CHIPs) are designed by CHCF Health Care Leadership Program participants with the goal of addressing meaningful challenges or opportunities in health care. 

Browse CHIPs to leverage the work of CHCF alumni and find opportunities to collaborate in order to improve health for Californians.

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White Coats for Change

Ilan Shapiro, MD, MBA

The White Coats For Change (WCC) project is a transformative initiative aimed at equipping and empowering health care providers to actively engage in civic activities and drive systemic change.
The project was born out of my frustration as a health care provider. I grew weary of prescribing solutions that I knew were nearly impossible for my patients to achieve. The need for a substantial impact in our community led me to seek an alternative approach. WCC is my response—a departure from temporary fixes, aiming to instigate genuine systemic change. It's my commitment to healing on a broader scale, both within individual lives and the health care system as a whole. There are 3 key objectives: (1) Learning about advocacy and civic engagement; (2) civic participation, and (3) Activation in health care policy forums to bring the voice of the community health care systems.

October 25, 2023
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Building a Better Adult Day Health Center in San Bernardino

Teri Rhetta, MD, MMM

As the population ages, we see many senior parents moving in with their adult children and grandchildren. Many of these caregivers need to work outside of the home, which leaves the seniors alone and unprotected. There are daytime options for supervised care, but Symphonie is an Adult Day Health Care (ADHC) center with an increased emphasis on quality and high-value care. Adult Day Health Centers provide supervised low acuity health care during the day which helps to lower rates of institutionalization. Symphonie provides care to both the special needs adult, but also to caregivers. The goal of my health improvement project is to establish an extended care model ADHC in the San Bernardino area.

October 25, 2023
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Getting to the Heart of Behavioral Health Quality: A Measurement Based Care Quality Improvement Program (QIP)

Jeffrey DeVido, MD, MTS

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. The program was funded by Partnership HealthPlan of CA, with funding obtained through behavioral health grants as well as ongoing incentive payment quality improvement initiatives.

October 25, 2023
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Vietnamese American Service Center

Tiffany Ho, MD, DFAPA

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. They also participated in designing a “one stop shop” where they can receive holistic care with primary care, pharmacy, labs, health education and other support services.

The Vietnamese American Service Center (VASC) was built in the heart of San Jose’s to address critical mental health needs of this underserved community. Over a span of one year the VASC was able to provide mental health services to 240 patients. Culturally responsive services provided include individual and group counseling, psychiatric services, crisis intervention and peer support services. Other essential services were also made available to this underserved community.

October 25, 2023
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Making Contingency Management for Methamphetamine Use Accessible to People Experiencing Homelessness

Jeffrey Norris, MD

Contingency management (CM), which involves paying people to use less meth or engage in treatment, is the most effective treatment tool for methamphetamine use disorder. Compared to CM, other treatments (like medications, counseling, detox, and rehab) do not work well for meth use.

Despite this, CM is not widely available due to legal, political, and operational barriers. To address this in California, DHCS is implementing a CM pilot in some counties through the Drug Medi-Cal Organized Delivery System (DMC-ODS). However, not all individuals needing CM services are able to access the DMC-ODS. This is especially true for people experiencing homelessness, for whom transportation, social, stigma, lack of insight, and other barriers prevent them from accessing DMC ODS services.

Meth use is especially problematic as people experience homelessness enter permanent supportive housing (PSH). Housing First models mean that individuals entering PSH are not expected to be in recovery. Continued meth us in PSH can cause major behavioral disturbances that can put the individual, their neighbors, staff, and the building in harm's way.

October 25, 2023
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Saving Our Caregiver Workforce with Dialectical Behavior Therapy (DBT) Interventions

Tiffany Sickler, PhD

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.

Koinonia implemented a low-cost, evidence-based, trauma-informed, relationship-focused, transferable, and sustainable. model across all levels of the agency, using the four main components of Dialectical Behavior Therapy (DBT) of Mindfulness, Emotion Regulation, Distress Tolerance and Relationship Effectiveness.

The aim of this project was to:

  1. reduce staff turnover rates,
  2. reduce caregiver attrition rates
  3. increase positive. Youth discharge outcomes.
October 25, 2023
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Building Organizational Excellence Within Olive View’s Hospital Operational Leadership Team.

Jessica Kuo, PharmD

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? My operational team consists of these ancillary and non-clinical staff who are similarly critical to the hospital. The purpose of my CHIP project is to develop my leadership team and provide them with the necessary soft and hard skills to drive behavioral transformation and performance improvement in alignment with the organization’s strategic initiatives.

October 25, 2023
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