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The 1998 Eleventh Annual Management Excellence Awards
Sponsored by: Certus Corporation
TOP HONORS
HONORABLE MENTIONS
TOP HONORS
Emergency Department Case Management Program
San Francisco General Hospital
Several studies have found that a large number of emergency department
visits are accounted for by a relatively small group of patients. These
high users—many of whom use the ED as their primary source of medical
care—often have significant medical disorders as well as psychological,
social and economic problems. To address this problem, the Department
of Psychiatry at San Francisco General Hospital conducted a pilot study
to determine whether intensive case management services could meet the
complex needs of these high users while decreasing utilization and costs.
The results were remarkable: emergency visits among these high users
decreased by 21 percent, inpatient hospitalizations decreased by 30
percent, homelessness decreased by 44 percent, and substance use decreased
by 38 percent. In addition, 32 percent of patients were successfully
enrolled in Medicaid and Social Security Disability programs. San Francisco
General’s Emergency Department Case Management program has served
more than 240 high user patients and is now being expanded.
Specialists in Baby Science
Natividad Medical Center (Monterey County)
In 1996-97, Natividad Medical Center saw a significant decline in OB
deliveries as patients shifted to the private sector. Focus groups showed
that Natividad’s competitor was seen as “high-tech” and
“high quality,” largely due to a “halo effect” generated
by the competitor’s marketing of its heart center. Public perception
of Natividad’s maternal child health services did not recognize
Natividad’s academic affiliations, use of the latest medical technology,
highly skilled staff, and other “exclusives,” such as the
only Level II nursery licensed by California Children’s Services.
To reverse this misperception, Natividad undertook a bilingual, multi-media
campaign called “Specialists in Baby Science,” highlighting
the high quality and comfort at Natividad’s Special Beginnings
Unit. The campaign included a series of print, radio and television
advertising, promotional giveaways, and a special 1-800 telephone number
to assist patients through a complex system and to help track the campaign.
As a result of this effort, OB deliveries, which had declined by 15
percent in 1996, declined by only 7 percent in 1997, and began to increase
again at the completion of the six-month campaign.
Preparing Unlicensed Assistive Personnel for
Role Augmentation
Rancho Los Amigos Medical Center (Los Angeles
County)
Rancho Los Amigos Medical Center was designated by the Los Angeles
County Department of Health Services as the pioneer institution for
facility-wide reengineering. As a result of these efforts and subsequent
work-redesign led by the Patient Care Design Team, a new assistive personnel
position—called a Rehabilitation Associate—was created to
meet the unique challenges of rehabilitation clients while also using
fewer resources. This new multi-skilled unlicensed worker combines the
skills of a nursing assistant with discipline-specific roles traditionally
occurring in physical therapy, occupational therapy, and speech therapy.
The interdisciplinary design team analyzed the core competencies for
these functions and developed a training program to assure that all
78 nursing assistants at the Medical Center could demonstrate these
competencies; some of these nursing assistants would be promoted to
the new Rehabilitation Associate position. The result was a unique,
cost-effective, efficient and creative training and evaluation program.
The Male Involvement Program of San Joaquin
San Joaquin County Health Care Services
Three of San Joaquin County’s most pressing problems are teen
pregnancy, lack of appropriate male role models in fatherless homes,
and juvenile behaviors that are inconsistent with community norms and
values. Without positive male role models, many young men perceive money,
sexual activity and violence as the ingredients of manhood, and many
young women grow up to believe that the absent or violent male is the
norm. The Male Involvement Program is a collaborative, comprehensive
service effort led by the San Joaquin County Public Health Services
in cooperation with four other community-based agencies. The program
promotes sexual responsibility rather than sexual activity through counseling,
concentrated street outreach, information and education to adolescent
and young adult men living in the county. The program serves over 1,500
young men annually in community and alternative schools, juvenile justice
facilities, group homes, community settings and recreational sites.
During the first two and a half years of the program, the teen birth
rate in San Joaquin County dropped an impressive 14.1 percent.
HONORABLE MENTIONS
Hoover School Children and Youth Health Facility
Project
San Mateo County Health Services
The North Fair Oaks section of Redwood City is the poorest area in
San Mateo County, and has been targeted by the Health Services Agency
for targeted health outreach. When San Mateo County General Hospital
completed its new AIDS clinic, nine modular buildings became surplus
space. The Hoover School Children and Youth Health Facility Project
is a collaboration of seven agencies established to relocate the 6,000
square foot modular buildings and bring together and provide space for
three distinct programs designed to meet the needs of this low-income
community: The Redwood City Youth Health Center, the Hoover School Family
Resource Center and a new Hoover School Pediatric Health Clinic. In
less than a year, the collaboration raised over $150,000 to relocate
and reconfigure the modular buildings to allow for the expansion of
much-needed services within this underserved community. This collaboration
ensures that students at the Hoover School will receive a quality education
at the same time they and their families have access to health services,
family support services, counseling, adult education classes and recreation
services.
Arthritis Empowerment Program
Olive View-UCLA Medical Center (Los Angeles County)
Arthritis is an extremely painful and disabling condition affecting
millions of Americans. The Arthritis Empowerment Program at Olive View-UCLA
Medical Center helps people with arthritis lead healthier, more active
lives through a series of educational sessions that teach participants
about all aspects of arthritis self-management. The program consists
of six weekly sessions of three hours each with a class size of no more
than 20. Each participant receives a course syllabus and other program
materials, including The Arthritis Self-Help Book, available in English
and Spanish. The Arthritis Empowerment Program has reached unprecedented
numbers of Spanish-speaking persons using a classic, grass-roots public
health approach. After the first four and a half months, 336 participants
graduated from the program—73 percent higher than anticipated.
These patients showed an 11.8 percent improvement in pain management
and a 31.6 percent improvement in self-efficacy.
Joint Venture with the Department of Veterans’
Affairs for a Stockton VA Primary Care Clinic
San Joaquin County Health Care Services and San
Joaquin General Hospital
In 1996, a group of veterans and their supporters held a town-hall
meeting with representatives from the U.S. Department of Veterans Affairs
and local officials to discuss the health care needs of veterans in
San Joaquin County. After determining that veterans needed a clinic
of their own, a decision was made to establish a joint venture between
San Joaquin Health Care Services and the VA Palo Alto Health Care System
to bring sorely needed medical care to honorably discharged veterans
residing in the county. The end result was a special five-days-a-week
VA clinic opened at San Joaquin General Hospital’s inpatient and
outpatient facility to provide primary care services to veterans. During
the first year of this joint venture, the clinic achieved the “Best
Customer Satisfaction Rating” in the VA network, handled 10,284
visits, and served 2,414 veterans, many of whom were potentially unfunded
patients for the county’s health care system.
CONGRATULATIONS TO OUR WINNERS!
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