California Health Care Improvement Projects (CHIPs)

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. Lots of evidenced-based practices exist for management interventions and clinical care decisions (e.g., goal directed therapy for heart failure or sepsis), but few standards are reinforced around the key education a patient should receive about their clinical diagnoses before they are sent home from the hospital. This project is titled “Inpatient University” as it aims to standardize a patient-centered curriculum to guide the empowerment of our patients. And it aims to make this education and communication as easy and seamless as possible for hospital staff.

There are three key aims for the “Inpatient University” project:
• Standardized education to be delivered to our patients throughout the course of their hospitalization,
• Simple written instructions given to patients at time of discharge, and
• Assurance that instructions on pill bottle labels dispensed from our Discharge Pharmacy are always translated into a patient’s preferred language.

White Coats for Change

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.

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. 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.