Message From the CEO
Anna Roth portrait cropped
Anna Roth, CEO
Contra Costa 2020: Bringing the Strategic Plan to Life 
Last year when we introduced our five-year strategic plan, now known as Contra Costa 2020, we unveiled our bold vision for the future: to make Contra Costa the healthiest community in the nation. We also identified our organization's guiding purpose -- to create optimal health for all through respectful relationships and high-quality service.
We're now moving full speed ahead with using the principles and aspirations in Contra Costa 2020 to guide our operations. Our strategic plan's three priorities -- patient and family centered, continuous improvement, delivering value -- are coming to life as we develop teams and tactics to implement our vision and establish metrics to measure our progress.

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Top Headlines
Global Health Fellowship Fundraiser a Success
Thanks to all who attended last month's fundraiser at the Pleasant Hill Community Center for our Global Health Fellowship. More than 100 people came to the event, which netted $11,500 to purchase medical equipment, such as point-of-care ultrasound devices, and help pay for fellows' travel expenses. The event was sponsored by the Contra Costa Regional Health Foundation. The Global Health Fellowship Program is an initiative of the Contra Costa Family Medicine Residency Program, works in collaboration with UCSF. The program is one of only six family medicine global health fellowships in the country. 
CCRMC Again Recognized for LGBT-Inclusive Policies
For the third consecutive year, Contra Costa Regional Medical Center has been recognized as a leader in healthcare equality by the Human Rights Campaign Foundation (HRC), the largest national organization advocating for lesbian, gay, bisexual and transgender rights. The Healthcare Equality Index, an annual survey conducted by the group, rated the hospital a "Leader in LGBT Healthcare Equality." CCRMC was one of only 15 county-run healthcare facilities to receive the designation this year. 

Emergency Departments in Contra Costa Agree to Opioid Prescribing Guidelines
To help address the epidemic misuse and abuse of prescription pain medications, all emergency departments in Contra Costa County - including ours - have adopted a set of safe prescribing guidelines for opioids. The guidelines were developed by the East Bay Safe Prescribing Coalition, which includes Contra Costa Health Services. The guidelines include general advice about when and how to prescribe painkillers an agreement to avoid prescribing long-acting drugs such as OxyContin and fentanyl, and recommended security practices to reduce abuse such as limiting amounts prescribed.

Contra Costa 2020 - Improvement Learning Session on May 31 
We are bringing together thought leaders and frontline staff in a dynamic setting to engage in an improvement learning collaborative across the continuum of care. Join staff, community and healthcare leaders at this important event and leave with new ideas, an expanded network of like-minded and passionate colleagues, and the inspiration to foster change. Registration is free and a continental breakfast and lunch are included. Space is limited so please register by Friday, May 13, 2016. 

To RSVP and get more info, contact event coordinator Miriam Rosa at  

News From Our Hospital
Boarders in the E.D. 
Improvement teams continue to work to address the ongoing issue of "boarders," patients who stay extended periods of time in the Emergency Department while waiting to be placed in a hospital bed.
Last month, the Emergency Department and the Department of Hospital Medicine implemented a new handoff process for patients admitted to the hospital from the E.D. Under the new process, admitted patients will be cared for by inpatient physicians and the medical officer of the day (MOD) - even if those patients are still in the E.D. waiting to be placed in a room. This process will improve patient handoffs and allow E.D. doctors to focus on new emergency patients being triaged, said Dr. Tom McCoy, chair of the department.
Over the past year, the inpatient flow and boarder teams have made significant progress in coming to understand the root of the problem. An analysis done last fall showed that 70% of CCRMC's boarder volume was attributable to a bottleneck caused by inpatients who don't need to remain hospitalized but are unable to be discharged. Many of these patients can't easily be placed in community care or rehabilitation facilities due to complex health issues.
Hospitalist Medical Director Dr. Felicia Tornabene said now that we understand the problem, we can try to come up with solutions - although she acknowledged the issue is complicated. CEO Anna Roth said she is hopeful that our new whole-person care program, Care Connect, will provide a longer-term solution.

Cafeteria to Stay Closed A Little Longer
The hospital cafeteria will remain closed at least until late May, according to COO Tim Thompson-Cook. It had initially been hoped that the cafeteria could re-open at the end of March. In the meantime, people can still get food at the temporary dining area on the fourth floor and the food trucks in front of the hospital. Visit iSITE for the latest updates. 

Farmers Market Returns  
The farmers' market is returning to CCRMC on May 10. The outdoor market--a partnership between Contra Costa Certified Farmers' Markets and CCRMC--will take place every Tuesday from 10 a.m. to 2 p.m. 
News From Our Health Centers 
Group Medical Visits - Making a Difference in Patients' Health
When a patient comes to a group medical visit at one of our health centers, they get to do much more than see the doctor. They spend 2-3 hours, over a series of sessions, with approximately 10 people with similar conditions, as well as with the doctor and support staff. They get their questions answered and their stories heard. They may get to dance or walk together, meditate, try a new food or prepare a healthy meal. And they have fun.

The Group Medical Visit Program offers diabetes groups in both Spanish and English at our Brentwood, Concord, PittsburgMartinez and West County health centers. There are also prenatal groups, pediatric obesity groups (WeCan), pain and wellness groups, and Choosing Change for patients formerly addicted to opiates.

Providers and staff have shared how their participation in the groups changed their expectations about patients' abilities to conquer lifelong habits. They enjoy getting to really know their patients and spend more than 15 minutes with them. Meanwhile, patients tell us that the groups make them feel that they are not alone.

Our data show that these groups really work. We are seeing reductions in hemoglobin A1c's and BMI percentiles.

To refer patients to a group, it's as easy as an internal referral order in ccLink!  If the visit type doesn't exist at your site, interested providers should contact Dr. Amy Gordon at 
Exam Rooms Being Added in Pittsburg and Brentwood 
Efforts to increase capacity continue in East County with the upcoming expansions of our health centers in Brentwood and Pittsburg. Nine new exam rooms in Brentwood are expected to be ready for use by August. Meanwhile, construction to add 15 exam rooms at the Pittsburg Health Center will begin this summer and finish in December. 
Martinez Clinics Sign Up Most Patients for myccLink 
The Martinez Health Center and Miller Wellness Center teamed up to enroll the highest percentage of patients in myccLink among our health centers during the first three months of 2016. For signing up the most patients for myccLink, the Martinez clinics will receive up to $500 from the Contra Costa Regional Health Foundation to pay for a celebration with food and drinks. Overall, nearly one in five empaneled patients at the Martinez clinics have activated their myccLink accounts since the online product was made available in 2014.

Click to enlarge. 
New Art Installation at Miller Wellness Center 
The George & Cynthia Miller Wellness Center recently unveiled its new permanent art collection, which includes paintings and mixed-media works by over 30 Bay Area artists.
The work was funded by the Contra Costa Regional Health Foundation. The foundation brought in Ann Schnake, a former county family nurse practitioner who is now an independent artist and curator, to build a truly site-specific body of work for the Wellness Center. Schnake worked closely with Rhonda Smith, a Foundation board member and volunteer coordinator for CCRMC. Through a lengthy conversation with staff, patients, and many stakeholders, the direction of the exhibition was teased out: imagery of change, re-imagination and recovery juxtaposed with that of stability and comfort.
The Miller Wellness Center is the latest CCRMC & Health Centers site to promote work by local artists. The West County Health Center has a large body of work developed between 1996 - 2012 by ArtsChange, a Richmond-based arts nonprofit. Murals were added to CCRMC's inpatient psychiatric unit last year by the Art of Health & Healing and exhibitions for the perinatal ward at CCRMC and Antioch Health Center are currently in process.
Digital Healthcare 
eConsults Link Primary Care Docs to Specialists
Blue Shield of California Foundation has awarded CCRMC & Health Centers a $100,000 grant to begin implementing an electronic consultation (eConsult) system to better coordinate care between primary care providers and specialists.
Over the past few years, the foundation has been funding eConsult pilots at several safety-net health systems in California with encouraging results. San Francisco General Hospital reduced its wait list for gastrointestinal services from months to weeks, said Dr. Gabriela Sullivan, Specialty Medical Director for CCRMC & Health Centers.
Dr. Sullivan, who is leading the eConsult project, said eConsult will help us meet benchmarks for specialty services under the latest federal waiver. In the coming months, Dr. Sullivan said, her team will assess our specialty-access gaps and develop new workflows. The new consult system will likely be piloted by cardiology and orthopedics. 

You Can Now Access Documents on iSITE From ccLink 
The ccLink training team has implemented a new feature in our electronic health record called "Learning Home Dashboards." These dashboards are customized according to user roles (such as ED nurse, ambulatory provider, inpatient social worker). Users can get quick and easy access to tip sheets and training materials, which are stored on iSITE, from within ccLink by going to their dashboards and clicking on the links provided there. The documentation opens in a new window, so users can get the instructions they need without leaving ccLink.

Coming Soon: Patients Will Be Able to Make Appointments Online 
Work has begun to make it possible for our patients to schedule office appointments online through myccLink, our patient portal. Testing will begin with a limited number of appointments and then expanded once it is confirmed that the process is working smoothly and properly for patients. Dr. Chris Farnitano, Director of Process Redesign and System Integration, said he hopes the online appointment-scheduling will go live this summer. 

Streaming Music for Patients Having Surgery
Patients having surgery will soon be offered the chance to listen to the music-streaming app Pandora before and after their procedures. Tablets have been obtained for the cause with the assistance of the Art of Health & Healing and a pilot will begin this month. Staff hope music will help keep patients calm during what can be a stressful time. CCRMC already offers cancer patients iPads with streaming services to use while receiving chemotherapy. 

Mental Health Clinicians to Start ePrescribing 
Psychiatrists at the county's mental health clinic in Richmond recently completed a successful pilot where they began ordering prescriptions electronically in ccLink. The shift away from paper prescriptions will facilitate coordination between behavioral health and primary care providers in our electronic health record. The pilot team plans to meet in May to discuss how to spread "ePrescribing" to other county mental health clinics.