UCSF Health FY18 Value Improvement Awards

Outstanding Use of Evidence-Based Research

Bard Tip Location System in Adult PICC

Elizabeth Sin

Prior to this initiative, 100% of Peripherally Inserted Central Catheter (PICC) insertions in adult patients required a chest x-ray to confirm for tip location prior to infusion therapy. This method caused delays in medication administration, increased cost of care, and potentially exposed patients to unnecessary radiation. Through the implementation of the evidence-based Bard Tip Location System, a real time electrocardiogram, the Adult PICC team reduced unnecessary chest
x-rays by 84% and reduced costs by $276K in FY18.

Outstanding Partnership Across Initiatives

CDI & Heme Malignancy

Donna Hays

Brandon Blonquist

John Hillman

Matt Wolden

Rebecca Olin

John Dzundza

Brian Holt

Adrienne Green

The Clinical Documentation Integrity (CDI) and Hematologic Malignancy project teams worked collaboratively together, complementing each other’s value improvement interventions and financial targets. As CDI focused on improved documentation, heme malignancy case mix index (CMI) increased to 5.35. Yet even with record CMI, heme malignancy reduced its cost per case by $2,530
in FY18, resulting in $4.5 million savings.

Age Friendly Health System: Inpatient & Outpatient

Stephanie Rogers

Brian Holt

Michael Helle

Carla Perissinotto

Gina Intinarelli

Adrienne Green

Age Friendly leaders in inpatient units and Care at Home team worked closely together to coordinate care for patients upon discharge, ensuring a smooth transition home. These teams also developed protocols to notify the care team when Care at Home patients were admitted to UCSF Health to ensure continuity of care. Collectively, the two initiatives yielded $3.6 million in financial value in FY18. 

 

 

 

Outstanding Engagement of Frontline Leaders

Periop Supply Standardization

Syna Chhan

Chris Bogan

Jake Limbert

Sandra Wienholz

Luther Mercado

Joan Pinotti

Kevin Pattinson

The Perioperative Supply initiative was led by frontline leaders in perioperative services and materials management, who worked together to reduce costs and standardize supplies. Together, they rolled out standardized carts which eliminated 70 items and ensured consistency in 80% of OR supply rooms. Most impressively, they consolidated supplies to open OR 23 and OR 29 for clinical space and surgeries.
This initiative yielded $2.1 million in savings in FY18. 

 

Outstanding Utilization of Visual Management

Age Friendly Health System: Inpatient

Stephanie Rogers

Brian Holt

John Hillman

Adrienne Green

The Age Friendly inpatient team incorporated excellent visualization of key metrics, including caregiver engagement, patient satisfaction, falls, time to OR, infection rates, length of stay and direct cost per case into their True North Board on 15 Long, thanks to Improvement Manager Brian Holt. At each quarterly report out in FY18, Dr. Rogers brought the multiple Age Friendly initiatives, including delirium reduction, Acute Care for Elders (ACE) and hip fracture co-management to life through creative, illustrative slides. Recently Dr. Rogers’ work was highlighted at the UCSF Health Strategy Retreat where she shared her team’s progress with the Chancellor, UCSF Health and School of Medicine leadership.

Outstanding Incorporation of Value Improvement into True North Board

PRIME

      Kristin Gagliardi

Sara Coleman

        Gina Intinarelli

     

The Program in Medical Education for the Urban Underserved (PRIME) did an outstanding job incorporating the many facets of their initiative into Population Health’s True North Board to track progress in real time. Accomplishments include exceeding the 90th percentile benchmark for cancer screenings, diabetes management, blood pressure management, tobacco screening & counseling, and flu vaccination; launching depression screening and treatment workflows; implementing the safety checklist for obstetric hemorrhage; and completing requirements for Baby Friendly Designation.

Best Use of Common Sense

Blood Product Cost Management

Joanne Wong

Even though it required additional work for UCSF, the Laboratory team took full advantage of an offer from our blood supplier for an early pay bonus. They paid the invoice each month within 10 days, yielding a monthly savings of 2% and more than $300,000 throughout the year.   

MRI Optimization

David Sostarich

Through extended evening and weekend hours, the Radiology team added 1,325 MRI appointments during FY18, increasing access for patients and providing more flexibility to staff while maximizing utilization of high cost imaging assets.  This initiative yielded $2.1 million in additional revenue in FY18.

Outstanding Commitment to Patient Satisfaction

Palliative Care

Eve Cohen

Kara Bischoff

John Hillman

Susan Smith

Over the summer, Palliative Care conducted interviews to understand if the Palliative Care Clinic was meeting the needs of patients and family caregivers. In addition to high marks for “likelihood to recommend” and “the clinic helped me feel more supported and able to cope with my diagnosis,” patient feedback included: “This is what healthcare should be like” and “we can't imagine UCSF services without palliative care. It's been the most effective and meaningful service offered to us.” This team of physicians, social workers, and nurses truly embodies the values of UCSF Health.

Safe Transitions Pathway

Jennifer Viner

Aldea Meary-Miller

Sarah Imershein

Michael Wang

Ralph Gonzales

Catherine Lau

Safe Transition Pathway’s goal of ensuring patients are placed in the most appropriate area for recovery post neurosurgery embodies our commitment to patient satisfaction. As a Caring Wisely initiative, the Safe Transition team made patient education and satisfaction a priority, creating pamphlets to highlight hospitalization expectations for various procedures. More than 80% of patients in the Safe Transition Pathway rated their experience as excellent and more neurosurgery patients gave positive marks to increased privacy and reduced noise in the
neurotransitional care unit than those in the ICU.

Outstanding Sport for Leadership of Multiple Initiatives

Rita Jew

Rita led four pharmacy initiatives focusing on drug waste, expense reduction, and revenue optimization totaling $17.5 million in net benefit in FY18.

Joanne Wong

Joanne inherited five value improvement initiatives when the former lab director departed UCSF.  Luckily, Lab’s ambitious value improvement initiatives were left in very capable hands with Joanne, who stayed on top of every detail, and her outstanding team of managers, Irene Lee, Joshua Nguyen, and Terrina Yamamoto, who had an active role in leading and tracking interventions. The Laboratory team’s initiatives yielded $5.6 million in financial value.

Julia Huang

Julia provided financial and project support to eight initiatives across pharmacy and laboratory, totaling $21 million in value. Julia was always willing to jump in and troubleshoot challenges, even teaching herself SQL in order to understand complex financial reporting. 

MVP for Leading and Coaching

Nina Pitts

Nina not only led the very successful radiation oncology value improvement initiative that yielded $8 million in net revenue, she also served as a coach to the radiology denial working group, advising the team on strategies to understand the current state and design interventions to reduce denials. She did this all while rebuilding the revenue cycle team within radiation oncology. Nina’s experience, institutional knowledge, intellect, and get it done attitude make her
an asset to any team.

MVP for Value and Quality

Donna Hays

Donna Hays and the Clinical Documentation Integrity (CDI) team she leads have a made a significant impact on UCSF Health’s quality metrics. Through Donna’s leadership and partnerships with physicians, UCSF Health is able to more accurately capture severity of illness and risk of mortality of our medically complex patients. This work contributes to improved measurement of our patient complexity (Case Mix Index), publicly reported outcomes (mortality rankings), and utilization (length of stay).