December 2018
What is "True North" and why is it important? Please read here to learn more.  
How are we doing with our True North metrics?
Please review our  current   True North scorecard that  continues to serve as one lens into our organizational priorities and performance. This month's communication focuses on our first quarter reflections.
What are the key takeaways from this month's scorecard?
If "red is opportunity", we have plenty of it after the first quarter of the year. As communications go out and payouts are rewarded for last year's IAP goals before the holidays, it's worth pointing out that we have significant work ahead to achieve similar success this year. Here are the IAP highlights so far:

  • Patient Experience: only 34% of units, practices and services are currently improving from last year; for physician communication specifically, we're at 36% improvement after achieving 67% last year. Our communication training courses are a great development opportunity that many providers, or groups of providers, have invested in to improve their skills.
  • Harm Events: it was a particularly challenging month of October for harm events but a month doesn't make a trend. However, in reflecting on the first quarter of the year, we need greater attention on (re)sustaining our CAUTI success from last year, increased focus on reducing our HAPIs (pressure ulcers), and deeper investigation into our increase in workplace injuries. 
  • Operating Cost per Case: This is a complex metric, but the primary reason we’re not meeting budgeted goals is due to increased operating expenses spread over lower patient volumes. Cost reduction efforts, both big and small, can make a significant impact.
Performance Improvement Executive Summary
Our 2017-18 Performance Improvement Executive Summary is now posted to our externally-facing UCSF Health Quality of Care webpage, which is slated for an upgrade in 2019. The summary provides an overview of our True North metric performance last year, but also offers examples of key accomplishments and programs behind the metrics. We hope future summaries better blend metrics with improvement stories that capture the people and teams making a difference.
News and Announcements
Scribe Program: What's New?
The Faculty Practice leadership continues to work towards reducing documentation burden for our physicians. The expansion of our scribe program is one key strategic investment to achieve that goal. After adding 98 new physicians to the efforts in the past year, scribes now support more than 140 physicians across ambulatory practices with plans to expand further in the future. This overview deck shares more about the program, including the notable impact for physicians on their self-reported efficiency, experience and satisfaction overall.
APeX 2018 Upgrade & Optimization Trivia
The APeX 2018 upgrade is slated for February 10th, 2019. It's the fourth major upgrade since our 2012 implementation and the last of our large upgrades. Subsequent ones will occur twice yearly, while we continue to build enhancements to optimize APeX on an ongoing basis. Interested in some APeX trivia? Since going live with APeX, almost 13,000 enhancements tickets have been fulfilled and 2500 new order sets modified. This amounts to ~5 enhancements and 1 order set per day! Overall, UCSF has accepted 74% of all updates offered by Epic, landing us in the top 75% quartile of Epic customers nationally. Not all updates offered are a good fit for UCSF but a goal of 80% is an internally set target by our clinical systems teams. Check out the new APeX Hub on our intranet site as it's designed to provide a single-source portal of information.
Grade "A" for Safety
There are many external bodies (and growing) that attempt to evaluate the quality and safety of care we provide at UCSF Health. Each may define quality and safety differently, weight the same metrics differently, and apply different risk adjustment modeling to those metrics. It's why it can often be confusing to see our performance appear different pending on the source. This past month, the Leapfrog Group announced their fall Hospital Safety Grades and both UCSF Medical Center at Parnassus and Mission Bay received an "A" grade. It's a testament to the care all of you provide to our patients.
Schwartz Rounds
This month's Schwartz Rounds will take place on December 14th at Mission Bay, Oberndorf Auditorium, and will feature "When Outside Forces Intervene: Maintaining Compassion in Times of Discord"; as with other Schwartz Rounds, the goal is to foster an open discussion about the emotional impact of caring for patients. Please see the flyer for additional details.
Looking for information from a past True North Newsletter? Please access them  here.