UCSF ADVANCED PRACTICE NEWSLETTER
September 2019
CELEBRATING
NURSE PRACTITIONERS
NURSE ANESTHETISTS
PHYSICIAN ASSISTANTS
NURSE MIDWIVES 
WE ARE MOVING AWAY FROM THE TERMINOLOGY, ADVANCED HEALTH PRACTITIONERS FOLLOWING A DECISION BY THE NOW APP ADVISORY BOARD. ALL THE UCs IN OUR SYSTEM USE ADVANCED PRACTICE PROVIDERS AS DOES BCHO AND MOST OF THE UNITED STATES. WE WANT TO ALIGN UCSF HEALTH WITH ALL THOSE SYSTEMS. WE HAVE ASKED FOR LANGUAGE TO BE SLOWLY CHANGED TO APP FROM AHP AS A RESULT OF THE DECISION.

IN THIS ISSUE


Highlighting APP Practice at UCSF Health

Women's Health HIV Program

APP UPDATES

Midwifery Week 2019
2019 Flu Season
Connecticut Expands APRN Practice
Free CME Event for GI Malignancies
7th Annual APP Conference
Links to other UCMC's APP Practice
First Inaugural UCSF Health APP Grand Rounds
Survey Results of the APP CME Utilization Report
Palliative Care Education Day for APPs
Asian Health Symposium - Sign Up
Pediatric Updates Conference - NAPNAP
Inpatient Documentation Workflow and Workflow Compliance
APP Academic Stipend
PA Legislation Passes In Missouri
ONE GOOD THING
Schwartz Rounds
GME Grand Rounds
Medi-Cal SPA Time Study for Ambulatory Providers
New APPs to UCSF Health for the 9th Cohort in 2019
Advisory Board Minutes - July 2019
California Healthcare News
UCSF Health Events Calendar
Center for the Enhancement of Communication in Healthcare
New AHP AHA Re-Certification Workflow
True North Metrics
APP Students at UCSF Health
Sharing your Expertise across the State and Nation
Caring for the Caregiver
SON Preceptor Opportunities and UCSF Health Preceptor Training

RECOGNITION, PUBLICATIONS, AND PRESENTATIONS

Ryan Wilson, PA and Elliazar Enriquez, LVN
Tom Farley, NP
Mary Lesh, NP


RESOURCES
Fun Discounts for UCSF Employees
Pager Box Update
2018/2019 AHP Advisory Board
Required Training in LMS
Face Card Process
How To Correct The Staff Directory
APP Resource Manual Link
Adding New Privileges
Scope Of Practice Details
Licensing and Certification Responsibilities
CURES Sign Up for Scheduled Medication Prescribing
BRN Link
DEA
HIGHLIGHTING THE ADVANCED PRACTICE PROVIDERS
APP UPDATES
CELEBRATE MIDWIFERY WEEK September 29th to October 5th, 2019
"Midwives Make a Difference"
The Women's HIV Program's History
by Janeen Rojas, NP

Photos compliments of Edward Machtinger, MD
The Women's HIV Program (WHP) at UCSF was founded in 1993 as the first clinic in the U.S. dedicated to the care of women living with HIV. Two providers--Susan Shea, NP, and Ruth Greenblatt, MD--had learned from their patients that the struggles of women living with HIV were distinct from those of the men who made up the majority in HIV clinics. With the conviction that women needed to be treated in a place where they would be acknowledged, respected, and supported to remain engaged in difficult medical care, Shea and Greenblatt envisioned and won funding for a broadly interdisciplinary clinic dedicated to holistic care and empowerment for women and girls living with HIV. It was truly the first of its kind. 

Fast-forward to 2019. Healthcare professionals and researchers of all stripes are engaged in a far-reaching and inspirational conversation about the effects of ACEs and trauma, social determinants of health and structural violence. Under the leadership of Eddie Machtinger, who assumed the medical directorship of WHP in 2004, WHP is now nationally recognized as a model trauma-informed primary care clinic, and WHP leaders are sought after to assist with training across disciplines within healthcare.   We continue to learn from our patients that we cannot separate chronic illness from the circumstances in which illnesses develop and the lives in which illnesses are experienced. 

I have the great privilege of practicing in the footsteps of Susan Shea, as part of a now fully articulated trauma-informed HIV primary care clinic. My role as primary care provider is by necessity very broad. I work intimately--inextricably--with an interdisciplinary team made up of social workers, psychiatric health professionals, nurses, physicians, pharmacists, case managers and family members.  Starting with the initial intake, a patient's psycho-social history is considered fundamental to conceiving of a plan of care. Our interdisciplinary team meets prior to each clinic session to share information about the range of issues with bearing on our patients' well-being. Visits with patients may include a case manager from the community, a social worker from within our clinic., and our clinical pharmacist. Conversations with patients aim for universal education, motivational interviewing, and shared decision making. Nested within the broader UCSF community, I feel confident our clinic is offering the very best care possible.
2019 Flu Immunization Process
Connecticut Expands Scope of Practice for Advanced Practice Registered Nurses
“An Evidence-based, Individualized Approach to the Management of Gastrointestinal Malignancies”
Thursday, September 12, 2019
5:30 – 6:00 PM: Registration and Dinner
6:00 – 8:00 PM: Meeting

San Francisco Marriott Marquis
780 Mission Street
San Francisco, CA 94103
Meeting Room: Foothill C, 2nd Floor
 
PROGRAM FEATURES
  1. • No cost to attend
  2. •  Interactive, case-based learning environment
  3. • iPads provided to enhance learning experience
 
AVAILABLE CE Credits
2.0 AMA Category 1 Credits™
2.0 ANCC Contact Hour(s)
THE 7TH ANNUAL STANFORD ADVANCED PRACTICE TOPICS IN ACUTE AND AMBULATORY CARE CONFERENCE
ADVANCED PRACTICE AT UC Medical Centers in California
A UC wide Advanced Practice Leadership Strategy Committee was formed a couple years ago to create a dialogue and share common processes that were more mature at some health systems than others and support each other in our collective efforts. The Committee includes members from all professions as well as senior leadership and advanced practice faculty and administrators. The following logos are links to activities at each campus that may relate to advanced practice. These may include conferences and grand rounds. You will note that some are more mature in their online presence.
Understanding the Clinician Role in the Resolution of Health Inequities -Black Maternal Health as an exemplar

Monica McLemore, PhD, MPH, RN, Associate Professor, UCSF Family Health Care Nursing
SAVE THE DATE FOR THE FIRST INAUGURAL ADVANCED PRACTICE GRAND ROUNDS AT UCSF HEALTH ON OCTOBER 3rd 2019.
IT WILL BE LIVE STREAMED FOR PROVIDERS and STAFF ACCESS AT MB AND PARNASSUS AND MZ

.
12NOON TO 1P.

LIGHT REFRESHMENTS WILL BE SERVED FOR THOSE IN ATTENDANCE AND WILL BE RECORDED FOR FUTURE REVIEW.
The CME and Education Time Utilization Survey for UCSF Health APPs
Results are below and information about what you are entitled to and how to use.
Questions and Answers:

You get 40 hours per year for paid education time that is coded in HBS as EDU but it is based on percentage appointment, so prorated.

EDU is different than required education such as online modules and AHA certification which are not from your education time and coded in HBS as INHOUSE EDUCATION.

There is no common CME reimbursement across clinical service lines. You must communicate with your service to know if anything is available.

The onboarding series are required and coded as INHOUSE EDUCATION and not regular clinical time.
APP Palliative Care Education Day

9A - 5P October 15th, 2019
Parnassus Campus
LPPH Auditorium

Free and inclusive CEs - 7 contact hours
8 th Asian Health Symposium – Open for Registration Now!

October 10-11, 2019
For primary care clinicians, especially those who provide care to Asian patients – Please register immediately!  
Date :  October 10 - 11, 2019 (Thu and Fri)
Time:   8:00am – 5:00pm
Place : San Francisco Marriott Fisherman's Wharf, 1250 Columbus Ave, SF, CA  
Annual Fall Conference 2019: Pediatric Updates
​October 5, 2019 
Mission Bay Conference Center at UCSF - 1675 Owens St #251, San Francisco, CA 94158 
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time_for_change.jpg
Updates regarding Inpatient Documentation and APEX revision to Ambulatory Documentation
We are going to pilot a change in the current dot phrase appearance in a couple Pediatric settings first then share the new workflow with all the inpatient settings and finally move to ambulatory last, given we have an ambulatory workflow that generally works. The Office of the President Audit Office is going to scrutinize our utilization of compliant workflows. I ran a report for the month of June 2019 and we had 2436/12559 total AHP encounter types that were not compliant. This is about 19% non-compliance and we need to get to between 5 -10% compliance. Admittedly the report likely has some flaws but I request that every AHP provider please attempt to incorporate the current smart phrase into all encounter types in ambulatory settings. We will start reaching out to providers to remind them to use the smart phrase.
I wanted to prepare you a change in documentation that will provide greater clarity to coders for independent work and capture all the inpatient work AHPs provide, that remains primarily hidden from view. It is important for AHP providers of care, to document their care visibly. This workflow will resolve hidden clinical care. You will continue to be able to incorporate into your template notes as is current practice. The choices of shared or independent visit types will be clearly identified boxes rather than a drop down. It will also provide an option to choose critical care documentation or not. We have a poor history of capturing billable critical care activity by all providers, which can occur in any clinical location, including ambulatory settings. It will work in any note type and is called a Smart Block.
You must be compliant with the current ambulatory documentation workflow until the change occurs. Please use the dot phrase ".ahpvisittype" We are being audited by the Office of the President and will be monitoring starting this month .
The UCSF Health Office of Advanced Practice has 15 supported stipends to offset the cost of AHPs presenting at an academic conference in their specialty. Podium/poster/panel presentations will be eligible. Other requirements listed in link below.
RECIPIENTS TO DATE:
Jessica Brennan, NP
Lissa Gray, NP
Ada Edwards, NP
Alisa Yee, NP
Sarah Kabatt, NP
Gabriel Schwartz, NP
Mary Lesh, NP
Maura O'Day, NP
Onica Kuch, NP
Claire Parker, NP
JacklinTong, NNP
Annika Erlich, NP
Sarah Zhang, CRNA
Jessica Blythe, PA
Carly Hoffman, PNP
August 15, 2019
Clinical Advisor Article
Legislation Passed in Missouri Increases Autonomy for Physician Assistants
Compliments of Diane Sliwka, MD
      
One Good Thing
Improving the Work Experience at UCSF
Issue 75
                                    
To make our True North "Our People" efforts more visible at UCSF, this communication provides a highlight of one enhancement, story or tip intended to improve the work experience for clinicians and faculty at UCSF Health.
Schwartz Rounds
Schwartz Rounds offer healthcare providers a regularly scheduled time during their fast-paced work lives to openly and honestly discuss the social and emotional issues they face in caring for patients and families. The focus is on the human dimension of patient care. Clinicians and staff have an opportunity to share their experiences, thoughts and feelings on thought-provoking topics drawn from actual patient cases. The premise is that health care providers are better able to make personal connections with patients and colleagues when they have greater insight into their own responses and feelings
GME Grand Rounds - inter-professional opportunity to share experiences.
IMPORTANT
Ambulatory APP Providers ONLY
Please complete the LMS module for this training to be included in the next time study. You will not be included in the dates listed below if you did not complete in the LMS system. Your participation will ready us for the next request from Medi-Cal.
The dates are randomly selected and to gain this valuable source of revenue, the time sheets must be completed and returned after signature in blue ink in a timely manner. We must have an 85% participation rate.
The following training link provides information that ALL ambulatory APPs must review to be included. ONLY APP providers that completed the LMS module will receive a link to the TIME SHEET when the next date is announced.
APP NEW HIRES COHORT 9 2019
Please welcome these new APP professionals
STARTING APP Cohort 9 for ONBOARDING July 2019
THEY ARE A GROUP OF NP AND PA PROVIDERS COMING INTO MANY DIFFERENT CLINICAL SPECIALTIES ACROSS THE UCSF HEALTH ENTERPRISE.
APP ADVISORY BOARD MINUTES
CALIFORNIA HEALTHCARE NEWS
A COUPLE ARTICLES RELEVANT TO ADVANCED PRATICE. YOU CAN SUBSCRIBE IF YOU WISH.
UCSF EVENTS CALENDAR
Enhancing Relationship Centered Communication Skills Professional Development for Clinicians
AMERICAN HEART ASSOCIATION CERTIFICATION WORKFLOW FOR APP PROVIDERS RENEWING THEIR BLS, ACLS PALS THROUGH SAFETY TRAINING SEMINARS

They have a list of authorized APP providers. All others will be denied.
UCSF HEALTH UPDATES REGARDING TRUE NORTH METRICS

Includes an article on price transparency.
For more information, contact Mitchel Erickson, NP Director of Advanced Practice
ALL APP STUDENTS AT UCSF HEALTH FACILITIES
All preceptors are required to ensure all students from ALL educational institutions have been vetted by UCSF prior to any educational activities, including employees. UCSF has many parts of the organization involved in this process. Their school needs an affiliation agreement with UCSF, they need health screening to be completed, they require online training for Health and Safety and APEX, and sign a HIPPA form.

Laura Frahm, RN in INEX is leading the effort to improve the on-boarding of all students and is building a portal that all schools and students must work through.
WANT TO SHARE YOUR EXPERTISE WITH APP COLLEAGUES ACROSS THE STATE, THE NATION, OR THE WORLD?
CARING FOR THE CAREGIVER
MORE INFORMATION AND TO BE A PEER SUPPORTER, EMAIL THE FOLLOWING LINK.
Are you a Clinical Preceptor?
Are you interested in precepting or becoming volunteer clinical faculty?
Presentations, Publications, Recognitions, and News
Pathways to Weight Loss Surgery Clinic Poster Presentation: Accepted to the ASMBS 36th Annual Meeting at Obesity Week 2019.
Ryan P. Wilson, PA-C, MSPAS, MPH; Elliazar Enriquez, LVN
Great Experience Award
Mary Wong, NP Cardiology
received a Great Experience Award on Tuesday, August 27 th at the Manager’s Meeting
Tom Farley, NP Adult Critical Care APP Manager - Author of an article published in Critical Care Medicine Journal
Article published:
Enablers and Barriers to Implementing ICU
Follow-Up Clinics and Peer Support Groups
Following Critical Illness: The Thrive Collaborative.
RESOURSE INFORMATION AND LINKS
UCSF EMPLOYEE DISCOUNTS AND BENEFITS FOR WORK, LIFE, AND FAMILY




Giants Tickets - 30d prior to games email tiny.ucsf.edu/sports

Six Flags - when buying tickets enter promo code UCSF

California Academy of Sciences - when buying tickets for 20% off use promo code UCSF

SF Zoo - use discount code 75001 for $3 off adults, $2 off children with one free train or carousel ride for each ticket

Monterey Bay Aquarium - discount using Store Name UCSF1002

Travel discounts - hotels, packages, cruises. Register for UCSF Passport Discounts, search UCSF Get Away Today

UPDATING YOUR PAGERBOX CONTACT INFORMATION IS IMPORTANT
 
In order for other providers to reach you or contact you outside the messaging feature in apex, pagerbox is another mechanism to utilize. This is an internal system and not available to patients. If you do not have a pager, please consider adding your contact information to the pagerbox system. You are only required to respond to pagerbox messages during your normal working hours. All Pagerbox services are now managed by UCSF IT Services.
Feel free to let me know of any problems. 

2018/2019 APP ADVISORY BOARD
Feel free to reach out to them through global Outlook
Alisa Yee, NP
Mercy Vigil, CRNA
Shelley Gierat, CRNA
Jennifer Kerney, NP
Laura Kirk, PA - Co-Chair
Maura O’Day, NP
Brandon Sessler, PA
Stacy Wong, NP
Eliana Agudelo, PA
Dana Morgan, PA
Samantha Shenoy, NP

Laura Weil, CNM
Annette Carley, NP
Gerri Collins Bride, NP
Mitch Erickson, NP
Lissa Gray, NP- Chair
Danielle Krieger, NP
Tara Valcarcel, NP
Stacie Rohovit, NP
Michelle Klosterman, NP
Ryan Wilson, PA
Check for any Required Training
THE APEX SMART PHRASE FOR AMBULATORY AND EMERGENCY DEPARTMENT ENCOUNTERS
This phrase MUST be present in ALL encounter notes. ONLY this phrase will work to capture your wRVU attribution. The billing logic was designed for ONLY THIS DOT PHRASE (.ahpvisittype)
FACE CARDS FOR APP PROVIDERS
Use the following web-link to complete the ordering process. The instructions are self explanatory. You do not pay but do need to create an account. You may upload a professional photo of your choice or use departmental professional photos for this purpose.

LINK TO WEBSITE (universal login)
Making yourself more visible at UCSF Health
In an attempt to ensure all Advanced Health Providers are visible to the public, your patients, and your colleagues at UCSF, please check and to ensure your working title and contact information are correct. Click the link below and complete the log in process and correct what you can. If your title is incorrect then an additional step will be required as this function is controlled by HR. If you find your title needs to be corrected, email me at mitchel.erickson@ucsf.edu with your hire title and I will collect information in batches and forward to the correct person. The "Find a Doctor or staff member" portal update is delayed. UCSF Health is building a new web portal and is challenged with migrating data from the old platform to the new platform. Once ready, we will have capacity to add all the AHPs with photos and CV related data. We have been authorized to develop a dedicated AHP Web portal at UCSF Health. More to come. 

 


This link will bring you to the UC ME login page. Use the button on the far left at the bottom to access the APP Resource Manual. 
This can be completed at the UC Me page by clicking on REQUEST NEW PRIVILEGE.
Look up your credentialed standardized procedures: Must be through VPN or UCSF computer.

Look up all the standardized procedures:

OMAG POLICIES
CIDP

FPPE/OPPE

This link will work from a any computer with/without VPN enabled using IE or Chrome.

Click on Professional Organization Links:
Physician Assistants - http://www.capanet.org/
Nurse Practitioners - http://canpweb.org/
Nurse Anesthetists - http://canainc.org/

All prescribers of Scheduled Medications will need to register and review upon writing Scheduled Prescriptions


IMPORTANT - RELATED TO YOUR DEA LICENSE
If your DEA license was issued in another state, you need to go online to the DOJ website and change the location to California. Your DEA needs to be in the state where you practice as all state laws are different.  YOU DO NOT HAVE TO PAY FOR DEA LICENSE OR RENEWAL AS YOU WORK FOR A PUBLIC INSTITUTION.

Very IMPORTANT message from BRN: As of Jan 1st, 2016 if you were licensed in California prior to March 1st, 2009 you are required to resubmit fingerprints via the new Live Scan Service. If your renewal seems to be in limbo for unclear reasons, this may be why. After Jan 2018, you will no longer receive a card license. Verification if online only.

This information was extracted directly from State organizations and agencies but does not infer any authority as to its content and you are reminded to check with your state authorities regarding statutes of practice in California. 
  
Renewal Applications Online
REVISED ANNOUNCEMENT REGARDING RENEWAL APPLICATIONS
Starting January 2017, DEA will no longer send its second renewal notification by mail. Instead, an electronic reminder to renew will be sent to the email address associated with the DEA registration. At this time, DEA will otherwise retain its current policy and procedures with respect to renewal and reinstatement of registration. This policy is as follows: If a renewal application is submitted in a timely manner prior to expiration, the registrant may continue operations, authorized by the registration, beyond the expiration date until final action is taken on the application.
DEA allows the reinstatement of an expired registration for one calendar month after the expiration date. If the registration is not renewed within that calendar month, an application for a new DEA registration will be required. Regardless of whether a registration is reinstated within the calendar month after expiration, federal law prohibits the handling of controlled substances or List 1 chemicals for any period of time under an expired registration.
If you have any suggestions regarding content or additions to the monthly newsletter, please send them to: (submission deadline is 1st of each month)