California Health Care Improvement Projects (CHIPs)

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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Maximizing 340B Revenue
Sommer Kaskowitz, DNP, FNP-BCCentral City Community Health Center, Inc. is a federally qualified health center that relies on 340B savings to supplement our care to the uninsured and underinsured communities we serve. Unfortunately, our 340B program has never been optimized to fully realize the full benefits of the program. In 2021, we were experiencing multiple organizational barriers including lack of 340B program awareness among our staff, not capturing savings from providers we refer our patients to, and many missed opportunities that led to potentially millions of dollars being left on the table.
A multipronged program was developed to address these challenges, including a quarterly training program, 340B resources for providers/staff/patients, referral capture, and implementation of an in-house pharmacy. The immediate goal was to increase 340B revenue by at least $1 million and begin referral capture by December 2023.
October 25, 2023View/Download PDF
Inpatient University: Empowering seamlessly
Gabriel Ortiz, MD, PhDOften, 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.
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Bringing Accompaniment to Inpatient Clinical Spaces: The Creation of a Health Advocate Program for Black Inpatients at UCSF Health
Sujatha Sankaran, MDNationwide, Black patients who are admitted to the hospital experience disparities in pain management, patient communication, length of stay, and readmission rates. This disparity is seen at UCSF Health, where black inpatients have lower patient communication scores, higher lengths of stay in the hospital, and higher readmission rates than the rest of the patient population. In addition, there is limited engagement and input from community members in the care that hospitalized patients receive at UCSF Health.
The aim of this initiative is to improve care for Black inpatients by hiring Black community health workers to act as advocates who accompany Black patients during their health journey. These health advocates improve care for Black patients by elevating the patient voice, helping patients navigate the complex health system, and providing teaching for patients to help them advocate for themselves during hospitalization.
October 25, 2023View/Download PDF
White Coats for Change
Ilan Shapiro, MD, MBAThe 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.
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Building a Better Adult Day Health Center in San Bernardino
Teri Rhetta, MD, MMMAs 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, 2023View/Download PDF
Getting to the Heart of Behavioral Health Quality: A Measurement Based Care Quality Improvement Program (QIP)
Jeffrey DeVido, MD, MTSThe 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, 2023View/Download PDF
Vietnamese American Service Center
Tiffany Ho, MD, DFAPAImagine 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, 2023View/Download PDF