I wanted to leverage resources to support standardization for county behavioral health plans. County behavioral health plans are responsible for the provision of behavioral health services to person with severe and persistent mental illness and services for substance use disorders to Medi-Cal beneficiaries in their counties. There are 58 counties in California ranging in size from smallrural to extra-large with much variation in how services are delivered.

I wanted to respond to the social climate of our world after the murder of George Floyd resulting in protests globally. In the midst of these protests, the COVID-19 pandemic ravaged the countries around the globe, highlighting health care disparities in its wake, including marginalized populations disproportionately affected by the pandemic. Our students at USC were no exception to the widespread outcry for social justice. They too were protesting and broadened their attention beyond social reform nationally focusing their attention on the social climate at USC demanding change.

Applied Behavior Analysis (ABA) is a type of behavioral therapy commonly used to treat children diagnosed with Autism Spectrum Disorder (ASD). The treatment is long-term, intensive, and highly individualized. If the service is poorly designed or implemented, it may lead to behavioral regression and the need to restart treatment. The goal of my CHIP is to improve the quality of ABA service with a PayFor-Value (P4V) program. Two metrics were used as lead indicators: 1) percentage of supervision conducted by board certified clinicians and 2) utilization rate of approved treatment hours.

I was working on a A3 to address racial equity in the workplace. Through the A3 process it was ascertained that 35% of staff did not feel comfortable discussing race and racism in the workplace, resulting in an organizational culture and environment unable to advance racial equity. The goal of the project was to continue the A3 process to advance racial equity by increasing staff awareness and comfortability (staff feeling safe) in discussing and addressing racism in the workplace. The target was 100% of staff would have comfort discussing racism in the workplace by December 2021.

I wanted to design a care model that was focused on delivering on the needs of clinicians as a primary intention. Too often I’ve found that in order to meet the patient needs sacrifices and compromises are made regarding the needs of clinicians in clinical program design. The common thinking is that it’s incumbent on clinicians to sacrifice for the sake of their patients. Instead, we interviewed clinicians on what were there most pressing needs and build our clinical care delivery program with those insights.

Telehealth has always interested me as a model of care to decrease barriers and increase access to care, but prior to the pandemic state of emergency there wasn’t a reimbursement model for FQHCs in primary care. We were doing some telehealth with remote specialists, bringing patients to the clinic for visits, but nothing in primary care or with remote patients. Then everything changed. Over 2 weeks in March 2020, we went from 100% in-person visits, to only 15%, the remaining 85% remote telehealth.

The politicization and circulating misinformation on the COVID-19 pandemic and vaccine has led to increased vaccine hesitancy. In particular, Black and Latino communities have suffered the burden of infections and death, yet lag in their vaccination rates. Based on experience, and research done on these local communities, we know that if information is scientifically accurate, but not adapted to the local contexts, people are less likely to trust the information and may look elsewhere for answers.

An educational program was delivered that led to improved confidence handling difficult interactions involving resident trainees (and faculty) with patient (and others). The prototype was developed and tested in 2020, feedback was incorporated and a 2nd prototype was tested in 2021. A survey of participants showed trends of improvement in communication and facilitation, increased effectiveness with implementation of new skills, and increased self-awareness.

The goal of the project was to separate the RN case manager role into two separate roles of care transition case managers and utilization case managers to achieve: • Improved care transitions across the continuum • Increased medical management • Increased efficiency in workflows and joy of work

I wanted to encourage professional growth, increase operational contributions, and improve staff retention for the medical assistants in ambulatory care across the organization. This project was personally important to me because 90% (525 out of 584) of the medical assistants in Stanford Health Care are women and women of color. The goal of the project was to develop a fair, realistic, and inclusive promotional ladder to incentivize medical assistants in the ambulatory care setting at Stanford Health Care.