Research Publications

For 25 years, Healthforce Center at UCSF has led the development and success of the next generation of California’s health leaders. Through its most longstanding initiative — the CHCF Health Care Leadership Program, funded by the California Health Care Foundation — Healthforce has designed a…

Moral injury is lasting psychological and spiritual distress that stems from violating one’s values or feeling betrayed by a trusted institution or authority. Moral injury is associated with post-traumatic stress (PTSD), depression, anxiety, substance use, functional impairments, and suicide risk.…

Most people’s perspective of health care carries an expectation that patients will be treated with kindness and empathy by health care workers. However as rates of burnout among workers rise, empathy and patience are in shorter supply. What can organizations do to support their staff to deliver…

Nationwide experts on rural health assert that leadership training would benefit health and health care in rural communities. Most available leadership development programs for health care leaders in rural and border regions of California are year-long hybrid or virtual only. Existing programs have…

The California Improvement Network (CIN) is a community of health care professionals committed to identifying and spreading ideas for better primary care delivery. This issue of CIN Connections offers ways to implement quality improvement efforts that intentionally advance health equity in primary…

Over the course of 12 years, the Blue Shield of California Foundation committed nearly $20 million to growing a pool of community health center leaders who were prepared to be effective agents of change in their organizations and in the safety net field. This signature investment, the Clinic…

The year 2020 has been unlike any other. The changes we’re now seeing in our clinics and through our screens, and the methods being used to address patient needs that we hadn’t previously considered will impact health care for years to come. This issue of CIN Connections features…

Between February 2020 when the COVID-19 pandemic began and August 2020, the nation has watched over 5.2 million individuals become infected and over 167,000 deaths. Unfortunately, many of the infections and deaths have been nursing home residents and staff. To date, the Centers for Medicare…

The California Improvement Network’s (CIN) latest report, CIN Connections: Foundations for Health, features tips for resilient leadership and building partnerships between health providers and community-based organizations from Access Community Health Network’s chief operating officer, Donna…

With rising costs, increasing burnout, and a rapidly changing environment, health care leaders may feel like they’re facing an uphill battle. This issue of CIN Connections features tips, advice, and actionable information for health care leaders to effectively lead change in their…

By 2030, California’s senior population will double to 9 million, but the state faces an estimated shortage of 200,000 home health and home care aides. To exacerbate the problem, California’s home health and home care aides are underutilized because of some of the most restrictive scope of practice…

In May 2018, 40 leaders and scholars from universities, delivery organizations, professional associations, advocacy groups, government agencies, and private insurance companies convened in Napa, California, for a Workforce Summit organized by the University of California, San Francisco, and…

In May, 2018, 40 national leaders and experts were convened to make workforce development recommendations that address the needs of persons living with serious illness in community settings. Over the course of two and a half days, attendees offered sixteen broad recommendations that included…

The United States will experience significant growth of the population older than age 65 in the coming decades, which will contribute to an increase in the number of people living with chronic and serious illnesses in the community. Field experts, policy makers, and health care…

The California Improvement Network’s report, CIN Connections: Healing the Healers, features actionable information to tackle provider burnout and promote well-being at health care organizations. It includes an interview with Mickey Trockel, MD, PhD, from Stanford Medicine WellMD Center,…

As the registered nurse (RN) baby boomers retire, there is a need for more highly skilled and experienced nurses in California, according to a new survey published by Healthforce Center at UCSF and the UCSF Institute for Health Policy Studies. This report summarizes the findings from the eighth…

This second report in a series of three Healthforce Center reports on primary care in California, unveils projections of a statewide primary care clinician shortfall in the next 15 years, with the most severe shortages in the Central Valley, Central Coast and Southern Border areas. Key Findings…

The aim of this study is to examine male-female earnings of nurses in Germany. Understanding and addressing differences in earnings by gender is important because differences in pay accumulate over a nurse’s career and can lead to substantial disparities between genders, especially if…

Is California prepared to meet growing demand for primary care? This report is the first in a series of three Healthforce Center at UCSF reports that will provide information to help policymakers, consumers and leaders of health care delivery organizations and educational institutions…

A survey of Arizona health care employers was conducted by the University of California, San Francisco (UCSF) in the spring of 2016. The survey captured responses from 59 percent of the community health centers (CHCs) in Maricopa County. This is the first survey of Maricopa County CHC employers and…

UCSF conducted the Survey of Health Care Employers in Arizona: Home Health Agencies, 2015 in the summer and fall of 2015. The survey elicited 25 unique responses, representing 11.4% of the total number of home health agencies in Arizona. Yuma, Gila, and Pinal Counties were not represented in this…

The 2010 Institute of Medicine report, "The Future of Nursing: Leading Change,Advancing Health," advocated for nurses to innovate in their practice, research, and education. However, little is known about the innovative behavior of registered nurses or whether there are differences in…

As health care shifts away from a fee-for-service model as a result of the Affordable Care Act (ACA), health care workers in California will be called upon to develop new skills and fill new roles.  The study’s authors analyzed state and national health care data and conducted in-depth…

This leadership report highlights the impact of Healthforce Center’s leadership programs across a diverse group of six leaders.  All six individuals graduated from their respective programs having significantly enhanced their leadership capabilities and made meaningful and measurable…

Policy & Politics in Nursing and Health Care, 7th Edition is the leader in helping students develop skills in influencing policy in today’s changing health care environment. Approximately 150 expert contributors present a wide range of topics in this classic text, providing a more complete…

Since its launch in 2008, the Clinic Leadership Institute Emerging Leaders Program (the Program) has been at the forefront of efforts to cultivate the leadership pipeline in California’s community health centers field. Created through a partnership between Blue Shield of California Foundation and…

The forces at play in today's health care environment are unprecedented. The Affordable Care Act (ACA), with its yet-to-be-defined impact on care deliver, the recent passage of California Senate Bill 493 (SB 493), and the "triple aim" goal to deliver better care to more people at a lower cost, are…

In 2005 the University of California, San Francisco (UCSF) implemented the Scientific Leadership and Management (SLM) course, a 2-day leadership training program to assist laboratory-based postdoctoral scholars in their transition to independent researchers managing their own research programs. In…

California’s community health centers face numerous challenges amidst a vast, complex and rapidly evolving healthcare landscape. Chief among these challenges is the need to adapt to changes in the healthcare system resulting from the Patient Protection and Affordable Care Act and remain solvent and…

This brief provides an overview of the CHCF Health Care Leadership Program and a summary of results from an assessment of the process and impact of a key component of the program, the California Health Improvement Project (CHIP). CHIPs are leadership projects undertaken by program participants at…