Highlighting APP Practice at UCSF Health
February 2022
Janet Yu Wu, DNP, AGACNP, RN Mechanical Circulatory Support

Joining UCSF Health in 2020 with the mechanical circulatory support team, Janet Wu, has recently been elected as Chair of the Best Practices Committee and Co-Chair for Research Committee at The International Consortium of Circulatory Assist Clinicians (ICCAC). The mission/vision of the Best Practices Committee is to serve as a framework for MCS Coordinator-driven care that is most current, evidence based, and compliant with regulatory standards. These directives represent consensus of the MCS community that are intended for multiple, diverse programs in achieving optimal patient outcomes. Their vision is to develop best practices and clinical pearls in the care of MCS patients through interdiciplinary collaboration. Their secndary mission is to serve as resrouce to new programs and novice MCS clinicians. Congratulations Janet.

Kristina Emodi, NP Urology Oncology
Kristina Emodi, FNP is the ambassador for UCSF with the National Bladder Cancer Advocacy Network (BCAN). They host annual walks but this year due to COVID it will be a virtual event. With only 1 more week to fundraise, UCSF is already leading the national platform. Donate to this organzation to help all the bladder cancer patients on their difficulty journey. 2022 Walk to End Bladder Cancer - Virtual Walk - Bladder Cancer Advocacy Network
Inpatient News

PRN Pain Order Set Administration Guideline
 Inpatient APPs must take action before 1pm on 3/2/022

What: The PRN pain medication order sets will be changing. Revisions will guide nurses' PRN medication administration based on a revised decision-making process. This is based on regulatory findings of inconsistencies between RN pain assessments and subsequent PRN pain medication administration
Who: Nurses on adult and pediatric inpatient units, emergency department and infusion centers
Why: This update follows evidenced-based guidelines for safe and high-quality patient care. Benefits to this approach are fewer adverse side effects (including opioid-induced respiratory depression) and reduced opioid requirements.
How: Orders favor administration of PO before IV starting with the lowest dose in the range (whenever possible). Instead of administering PRN pain medication based on mild/moderate/severe, or a numeric rating scale, PRN pain orders will soon include an individualized, multimodal approach. Examples may include:
  • First-Line: options may include PO non-opioids or PO opiod for patients already on scheduled non-opioids
  • Second-line: adjuvants (e.g., gabapentinoids, alpha 2 agonists, antidepressants, muscle relaxants)
  • Third-line: Opioid PO or IV
  • Breakthrough/emergent pain: medications to treat acute pain that is not relieved by existing PRN or schedule pain medication orders. Considered to be emergent pain relief which supersedes the first, second, or third-line therapy options.
  • Procedural pain: Medication given prior to activity known to induce pain (e.g., complex dressing changes, ambulation, drain removal, etc)

Providers will receive messages (email, Voalte, pages) about
REQUIREMENTS TO REVIEW AND CHANGE ALL prn pain medication indications on Wednesday 3/2/22 before 1pm.

Recorded Provider Education via link:

For questions, please contact the following providers:
Adult: Cat Lau ([email protected]); Matthias Behrends ([email protected])
Pediatrics: Amber Borucki ([email protected]); Mike Lang([email protected])
NEW Suicide Workflow

Inpatient Adult Core Admission Orders and
IP Gyn Adult Core Admission Orders

Within the the above Core Admission Order sets, an order to "Complete C-SSRS" (Suicide Screen) is pre-selected, this is the default. Providers need to read and respond to the required question. If answer is "Yes" or "Unable to assess" then this auotmatically triggers an order for the nurse to perfrom a C-SSRS. Based on the C-SSRS, a risk rating is generated. This rating then leads to specific precautions, orders and consults.
BCH Enterprise Town Hall
View the recording of February 1st town hall here

Lee Atkinson-McEvoy, MD, Division Chief of General Pediatrics, UCSF
Judie Boehmer, MSN, RN, Chief Nursing Officer BCH
Matt Cook, President, BCH
Brandie Hollinger, RN, DEI Co-Chair, Assistant Patient Care Manger PICU
Kelley Meade, MD,  Interim Chief Medical Officer, BCH Oakland
Ted Ruel, MD, Chief, Division of Pediatric Infectious Diseases and Global Health, UCSF
Steve Wilson, MD, PhD, Chief Medical Officer, BCH San Francisco / Chief Clinical Strategy Officer, BCH. 
APP Education Committee News
The APP Education Committee is pleased to announce that the frequency of Grand Rounds will be held monthly (previously twice a year). You can find the 2022 full lineup of topics, speakers and dates as well as prior recordings on the UCSF APP website or by simply clicking here. The next Grand Rounds will be March 9, 12-1pm featuring Julianne Blythe, Senior PA, UCSF Sleep Disorders Center.
  • Earn 1 hour CEU for UCSF RN/NP/CRNA/CNM
  • Search by title: UCSF APP Grand Rounds: Current Treatment Options for Sleep Disorders
  • Category 2 CME for PA, no additional registration required. 

Academic & EBP Immersion Program Stipends

Want to pursue EBP in your clinical setting but are in need of more formal education? There are funds available to support your virtual attendance at the FULD Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare.

Are you presenting an paper or case study at a specialty conference and want financial support for traveling expenses? Academic stipends are available.
APP Standards & Compliance Committee News
**ACTION REQUIRED** How important do you think coding is to being an APP at UCSF?
Not at all
Very important
The Coding Corner

** ACTION REQUIRED *** see poll

This Months Coding Tip: For Ambulatory APPs

Do you review patient records, coordinate care and do other activities related to patient care on a different day than the visit day?

If yes, you can bill for the time spent doing the above by using the code 99358/99359 prolonged services code.

SmartPhrase (.PROLONGEDSERVICESAMBULATORY) has been simplified to make it easier to document these patient care activities when billing for these prolonged services

Do you have other questions about coding?

Log on any Tuesday or Thursday and the UCSF Compliance education Team will help you.

Tuesday: 7-730am
Meeting ID: 938 2781 7739
Password: 637983

Thursday: 12-1230pm
Meeting ID: 974 4789 6211
Password: 327355

Click on this 15 minute video to learn how to use APeX for Diagnosis Coding

For more coding tips/FAQs

Other comments/questions: submit email to [email protected]
Justice, Equity and Inclusion Committee News

Nikole Hannah-Jones is a righteous giant of our times. She is a Pulitzer Prize-winning reporter covering racial injustice for The New York Times Magazine and creator of the landmark 1619 Project.

Please take the time to listen to one podcast at a time and share it with others.

Part II:
"Racism: A Social Determinant of Health
Now What do WE do?"
Celebrating Black History Month in the
School of Nursing
The School of Nursing warmly invites all UCSF Health Department of Nursing and all members of the UCSF Community to an upcoming presentation by UCSF Presidential Chair 2021-2022: Camara Jones, PhD, MD, MPH.

During Part I of the presentation held on Dec. 8, 2021, Jones outlined a framework for naming racism as a social determinant of health: acknowledging racism exists, that racism is a system, and racism saps the strength of the whole society. 
In Part II, on Wednesday February 16, 2022 4-5pm, Dr. Jones will dive deeper into the system of racism, how it works, what it looks like, and will discuss moving to action: dismantling racism.

For more information, go to

Register to automatically receive an email confirmation with the Zoom link to join:

Professional Development News
Messages from the Director Advanced Practice Providers and Clinical Systems, Roseanne Krauter, FNP-BC, CORLN

The Office of Advanced Practice Providers wants to ensure the voices of all APPs at UCSF Health are heard. Research indicates that the electronic health record (EHR) is one source contributing to clinician burnout. We would like to know how APeX, specifically In Basket work, impacts your patient care delivery and job satisfaction. With this intention, please complete this survey so that we may collect your valuable input.

UCSF APP In Basket work, Medical Advice Messages, and On-Demand Visits
Time estimate: <5 minutes
Population surveyed: UCSF Health APPs
Purpose: to understand In Basket workflows and coverage patterns, impacts on job satisfaction, and utilization of medical advice messages and on demand visits.
Open: January 31st – February 19th 2022

Responses are anonymous
Providing feedback allows us to use an evidence-based approach to formulate countermeasures and assess outcomes with the aim of improving APP job satisfaction at UCSF Health

ARCH survey
In our commitment to UCSF Health’s vision to be the best place to work and to provide care, our informatics team has partnered with KLAS Research on an initiative called the APeX Experience Project.  
Through this initiative, we will use quantitative and qualitative survey data to understand EHR (APeX) satisfaction and opportunities for improvement from the perspective of our care team members. UCSF Health operational stakeholders and the APeX Experience Project

Team will use the data to inform, propose, drive, and measure the impact of
countermeasures. Ultimately, engagement in the project will empower UCSF Health improve EHR satisfaction amongst our users. Additionally, the initiative will enable us to benchmark our results against similar organizations and share
industry best practice insights. The survey will be sent to our care team
members on February 28, 2022.

Please reach out to the APeX Experience Project Team should you have
any questions. 
A Message from the Director of APP Professional Practice,
Brandon Sessler, MMS, PA-C
Leadership Academy for the Advanced Practice Providers (LEAP)

Now accepting applications until February 25th

In partnership with the UCSF Health Office of Advanced Practice Providers, the Leadership Institute is excited to offer the Leadership Academy for the Advanced Practice Provider (LeAP). This innovative nine-month leadership training program is for physician assistants, nurse practitioners, certified nurse-midwives and certified registered nurse anesthetists. This initiative features some pre-work, nine monthly four-hour leadership learning sessions, two executive coaching sessions
and completion of a leadership project.

The UCSF Health Office of Advanced Practice Providers will sponsor 20 participants in this inaugural cohort. If you are interested in participating in the first cohort of this program, please complete this application

For more information, view this webpage and also contact [email protected] or Justin Pohl, Director Leadership Institute. [email protected]
Chat with your Chief Nurse Executive, Pat Patton
CNE Pat Patton, DNP, RN will be holding office hours every other Tuesday.
Log in and chat

Upcoming dates
Tuesday February 15, 2022 8-830am
Tuesday March 1, 2022 8-830am

Webinar ID: 915 1050 6382
Passcode: 131521

New APPs who joined the UCSF workforce

Sachindra Rayamajh, CRNA
Robert Tamblin, NP Geriatrics Mt Zion
Jeffrey Chou, NP Urology Practice Parnassus
Helen Zhu, PA Plastic Surgery
Brittany Okimura, PA Plastic Reconstruction
Alex Martinelli, NP ICU
Sarah Elgart, NP Womens Health
Tessa Rubin, NP Primary Care China Basin
Jennifer Perryman, NP CT surgery

California Association of Nurse Practitioners (CANP) Golden Gate Chapter is seeking to sponsor delegates during the upcoming in-person House of Delegates (HOD) on May 2, 2022 in Sacramento, CA. To qualify, you must be a current CANP Golden Gate Chapter member. HOD is the voice of all CANP members and is the legislative and policy-making body of the Association. Lobby Day is taking place the day following HOD, though not required, delegates are encouraged to stay on to attend lobby day. For more information, contact Geoff van den Brande, President SF Bay Area Golden Gate Chapter, [email protected].

CANP will be holding its annual Educational Conference in person and virtually Mach 31-April 3, 2022. Katie Duke, board-certified acute care nurse practitioner and TV personality, deliver a special keynote address. She is widely recognized as a leader in the nurse empowerment and entrepreneurship real. Click here for more information to register.
Mentor and Mentee
Stuck in a rut? It can be easy to feel this way once you've been in your career for a while. Mentoring can help you expand your perspective, become a better leader, build community, exercise emotional intelligence and challenge yourself. Whenever you teach or provide guidance to someone else, it can help reignite your own career motivation.

Do you feel as if you need a mentor? Enroll in the program to be matched up with an APP who can speak from experience or point you in the right direction.

If you have questions, please reach out to [email protected]

APP Mentee Application

Teach for UCSF Certificate Program

Improve the quality and depth of your teaching skills

APP Job Corner
Each month you will find the most up to date list of all UCSF Health APP open positions. Refer a colleague and if that colleague is hired, then you may be eligle for a referral award. For more info: referral program
There are over 125 available positions
Spread the word and save the date for April 7, 2022.
Inaugural UCSF APP virtual open house.
Wellness News

Can you name the 7 Pillars of Wellness?

  1. Emotional
  2. Physical
  3. Social
  4. Financial
  5. Environmental
  6. Career
  7. Spiritual

Each month resources and news about one of the Wellness Pillars will be featured here.

Sign up for the UCSF Wellness and Community Newletter to receive the latest discounts, events and wellness tips.
**Action Required**

Please take this survey to provide feedback on the monthly APP newsletter. We want to hear from you.
Do you have questions about your APP practice?

Email the Office of Advance Practice Providers: [email protected]

Click here to share this newsletter
Ivette Becerra-Ortiz DNP, MPH, NP, RN, NEA-BC, C-PNP
Chief of Advanced Practice Providers
Alisa Yee, MSN, ACNP-BC
Director of Operations
Roseanne "Rosie" Krauter, FNP-BC, CORLN Director of Advanced Practice Clinical Systems
Brandon Sessler, MMS, PA-C
Director of APP Professional Practice
UCSF Health PRIDE Values Professionalism • Respect • Integrity • Diversity • Excellence