November 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 what's new with our antimicrobial stewardship programs and medication safety.
How does antimicrobial stewardship contribute to our  C. difficile improvements?
Over the past 3 years, we've seen our hospital-onset  Clostridium difficile  infection rate drop from 11.75 per 10,000 patient days to 8.24, a ~30% reduction. The significant improvements are attributed to interventions that range from vigilant hand hygiene, diligent infection prevention practices (e.g., isolation precautions, room cleaning, etc.), improved testing stewardship, and targeted work on units most affected. However, one of the keys to success is the maturity of our antimicrobial stewardship programs. Led by Rachel Wattier (pediatrics) and Sarah Doernberg (adult), strategies designed to optimize stewardship (e.g., evidence-based guidelines, service-specific protocols, proactive screening and consultations) are helping shift culture and practices for hospitalized patients. If you're interested to learn more, please review recent updates about our children's  and  adult  programs.
What medications are we focusing on to prevent patient harm?
Last month, we announced a few changes to this year's harm events. One of those changes is providing greater visibility to the highest risk medications we administer: antineoplastics, anticoagulants, opioids, and insulin. We're calling out harm associated with those medication classes with a goal to reduce the 54 events that occurred last year. Improvement teams focused on these high-risk medications are constantly looking to improve our prescribing, administering and monitoring practices.
News and Announcements
Announcing New Medical Directors
Did you know that UCSF Health supports more than 130 physicians through formal medical directorships? In these critical roles, physician leaders partner with health system leaders to lead and support clinical operations (e.g., ambulatory, inpatient, affiliates/partners, and/or across the continuum) and functional areas (e.g., informatics, population health, quality/safety). With the growth of UCSF Health, we've had 39 faculty either appointed in new roles or taking over existing ones in 2018; they are captured here with brief bios as it's an impressive group.
Influenza Season: Get Vaccinated & Encourage Your Patients
Given CDC's report of 900,000 hospitalizations and 80,000 deaths from influenza last year, we can all play a role in supporting public health prevention. Have you received your flu shot yet? Do you have the new green "flu" sticker proudly stuck to your ID badge? Our Occupational Health clinics have administered nearly 7500 flu shots so far. For our patients, we hope to sustain or improve on our 99% screening and vaccination if indicated rate from last year. The CDC states that "a recommendation from a health care provider is the most important factor" in influencing immunization. Our own Coleen Kivlahan was featured in a UCSF Primary Care patient-facing video last year to address common myths about the flu vaccine. Lynn Ramirez and Debbie Yokoe (our children’s' and adult infection control medical directors) were quoted in a recent Huffington Post piece ( Will Getting the Flu Shot Actually Make You Sick?) about similar myths.
Teach for UCSF Certificate in QI & Patient Safety
Are you looking to prepare yourself for specialized teaching with a focus on QI and patient safety? The Teach for UCSF Certificate Program is a wonderful professional development opportunity and now they're offering a specific focus for those committed to educating learners (or other faculty) about improvement work. Please see attached flyer for more details.
Schwartz Rounds
This month's Schwartz Rounds will take place on November 13th at Parnassus, HSW-301, and will feature "Giving Thanks, Receiving Thanks: Sharing Stories of Gratitude from Our Work; 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.