reprinted from Issue 18, Spring 2014 of Frontiers of Medicine (PDF)
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"Philanthropy is often focused around discovery of new treatments," says Niraj Sehgal, MD, MPH, the Department of Medicine's associate chair for quality and safety.
"In addition to supporting the development of vitally important therapies, there is also a need to support the science that allows us to improve the delivery of care we provide. Even when we know the right thing to do for patients, plenty of evidence suggests that a focus on the delivery system is the primary driver to improved quality, access to services, and patient-centered care." To help meet this need, the Rotasa Foundation recently made a generous gift to improve quality and safety at UCSF. Their gift will support two initiatives:
Patient Advisory Council:
We spend significant time and energy trying to create a patient-centered health care delivery system, but have not been very systematic about incorporating patient input in this process," says Sehgal. To help address this, the Department of Medicine will be recruiting patients to serve on an Ambulatory Patient Advisory Council at UCSF Medical Center. Patients will meet regularly to provide feedback about ways to improve the patient experience across the department's outpatient clinics. The group will also include medical students and residents who will help develop specific interventions focusing on some of these ideas, and these projects will be presented at the annual Department of Medicine Quality and Safety Symposium.
"Having the patients' voices makes the stories much more real and personal," says Sehgal. "When a patient says, ‘This was my experience,' it's often more compelling than me telling a group, ‘We need to communicate and work better as a team.' This new initiative will really help drive improvements in the quality of care we provide."
Action Research Program:
UCSF recently piloted the Action Research Program on the Parnassus campus, in which faculty and medical students identified "hotspots" or specific bottlenecks to delivering more efficient and high-quality care. For example, demand greatly exceeds supply for UCSF Endocrinology clinic appointments. The Action Research Program team worked with clinic staff, nurses and leaders to develop ways to increase new patient visits, such as reducing no shows and late cancellations with pre-visit phone calls, and providing patients with follow-up phone visit options. It also became clear that medical students could perform many of these activities.
With support from the Rotasa Foundation, the Action Research Program will expand to San Francisco General Hospital. "We are excited to use this team approach to help improve care for vulnerable populations, while providing medical students with a front-line clinical experience that will help them appreciate the patient perspective early in their clinical training and teach them strategies for improving the health delivery systems in which they will be working," says Ralph Gonzales, MD, MSPH, associate chair for ambulatory care and clinical innovation for the Department of Medicine. "Some of the very problems that hinder care delivery can become opportunities for learning, and trainees, clinicians and patients can all benefit from successful interventions that emerge."
"We are tremendously grateful to the Rotasa Foundation for investing in the Department of Medicine's quality, clinical and training innovations," says Sehgal. "These pilot programs have the potential to not only improve care for our patients, but to serve as models that can be disseminated more widely."