February 2019
What is "True North" and why is it important? Please read here to learn more.  
Achieving Our True North
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 mortality review process and our learning health system pillar.
What are we learning from our "real-time" mortality review pilot?
Last year, led by Kiran Gupta and Janice Hull, we overhauled our process for reviewing, analyzing and learning from inpatient deaths. The primary drivers for change included a desire for a timelier process, less redundancy in having multiple groups review the same case in dyssynchronous fashion, better engagement of providers involved in the case, and a more supportive approach when deaths occurred. The 6-month pilot on selected services (264 deaths; 59% of all deaths) demonstrated a few key outcomes: 1) 97% of deaths were reviewed by at least ONE provider, 2) nearly 70% were reviewed within 5 days (this could have been weeks/months in the past), 3) 17% were referred for further review and action on systems of care or quality of care issues, and 5) 100% of providers were offered support through the Caring for the Caregiver program. We continue to identify themes and improvement opportunities (e.g., care impacted by throughput challenges, transfers from outside facilities, etc.) as we expand the pilot across all services in the coming year.
How are we engaging trainees in improvement work?
During our last Quality Improvement Executive Committee, we invited Edgar Pierluissi and Glenn Rosenbluth to share remarkable improvement work being led by our medical students and residents/fellows, respectively. The UCSF Bridges Curriculum provides opportunities for students to embed in a clinical microsystem and contribute to meaningful improvement projects. The UCSF Resident & Fellow QI Incentive Program provides similar opportunities for trainees to select improvement projects within their clinical area. Both programs have created impressive alignment to UCSF Health goals, adoption of A3 problem-solving frameworks, increased visibility on local True North boards, and measured impact from their efforts. Their presentations are provided here .
News and Announcements
Influenza Season: Protect Yourself, Your Patients & Colleagues
We're in the middle of influenza season and it's important to continue focusing on important recommendations:
1) Vaccinate yourself and your patients, 2) Stay home if you're sick with respiratory symptoms (see guidelines here ), 3) Place your patients on droplet isolation if they have respiratory symptoms, 4) Please prohibit visitors with respiratory symptoms from visiting the hospital, and 5) CLEAN your hands often. If you're looking for 2 minutes of entertainment, here is a hand hygiene video that was featured on the Jimmy Kimmel show during a past flu season.
UCSF Health & Price Transparency
Staring in 2019, the Centers for Medicare and Medicaid Services (CMS) began requiring hospitals to post online standard charges for their items and services, as well as inpatient diagnosis-related group (DRG) average charges. While our pricing information has been available online for more than a decade at the CA Office of Statewide Health Planning and Development (OSHPD), we now have these posted on our UCSF Health website . If you've followed the media coverage of this change, you know that pricing transparency is a complex issue that often raises more questions. Our UCSF Health Finance team provided a brief set of summary points that are worth reviewing if you want to learn more.
APeX Upgrade & SOGI Data
As part of our upcoming February 10th APeX Upgrade, we will implement functionality to accurately capture sexual orientation and gender identify (SOGI) preferences. The clinical tools will foster display of patient's chosen name, gender, and selected pronouns broadly throughout APeX. This will further support our desire to create an inclusive environment for our patients. The changes will require training and new operational workflows that will get tested in our primary care clinics first. It will also us another lens to understand whether we have healthcare disparities to eliminate.
Schwartz Rounds
This month's Schwartz Rounds will take place on February 12th, 12-1 p.m. at Parnassus, N-225, and will feature "The Complexity of the Pediatric to Adult Patient Transition"; 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.