UCSF ADVANCED PRACTICE NEWSLETTER
May/June 2019
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CELEBRATING PROFESSIONAL
NURSE PRACTITIONERS
NURSE ANESTHETISTS
PHYSICIAN ASSISTANTS
NURSE MIDWIVES
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Formal Apology: I recognize that I was unable to prepare and send the May newsletter due to several demands of the Office and then I left on vacation for 2+ weeks. Here is a combined May and June.
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IN THIS ISSUE
Highlighting AHP Practice at UCSF Health
CRNA's Experience in Guatemala
AHP UPDATES
AHP Communication Committee's Request for membership
Medi-Cal SPA Time Study for Ambulatory Providers
AHP Academic Stipend
New AHP AHA Re-Certification Workflow
2019 Nursing Week Awards
UCSF Health's Relationship with St. Mary's - Update
Best Health Care Jobs
UCSF Health's Annual Improvement Symposium AHP Presentations
Schwartz Rounds
National Subcommittee Opportunity at CMS
Advanced Health Care planning for Providers
GME Grand Rounds
New AHPs to UCSF Health for the 8th Cohort in18/19 FY
Committee Opportunities for AHP Advisory Board - please volunteer
Advisory Board Minutes - April 2019
California Healthcare News
UCSF Health Events Calendar
Center for the Enhancement of Communication in Healthcare
True North Metrics
AHP 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
Jessica Berennan, NP
Laura Kirk, PA
Trina Sheedy, PA
Jay Hunter, PNP
Jen Cademartori, NP
Lisa Catelli, NP
Ann Marie Torres, NP
Regina Gould, PA
ONE GOOD THING
Compliments of Diane Sliwka, MD
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
AHP Resource Manual Link
Adding New Privileges
Scope Of Practice Details
Licensing and Certification Responsibilities
CURES Sign Up for Scheduled Medication Prescribing
BRN Link
DEA
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HIGHLIGHTING THE ADVANCED HEALTH PRACTITIONERS
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Article by: UCSF Health's CRNAs on the left is Candacean Lansenderfer and on the right is Stacie Smith
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This was for both of us our virgin mission trip to Huehuetenango, Guatemala in February 2019. We had no idea what to expect, so we prepared for everything. The bus trip from the airport took roughly 7 hours, at least the bus was air conditioned. Our flight to the bus, was double that time, at least we had air conditioning. We were told that even the “iron stomachs” would likely get soft, so we brought our arsenal of prescribed medications (scopolamine, zofran, ativan, to name a few). Luckily, no one got sick, but we were exhausted when checking into the hotel. Unfortunately, a wedding party was going on, some rooms wouldn’t be available until the next day, but at least we thought “we have air conditioning”, we didn’t. After the visual sweep for unwanted bed guests, we found sleep to be elusive as the wedding festivities continued.
Early am wake-up and off to the hospital. Arriving to the OR, we were instructed to wear caps, shoe covers and cover gowns (recycled) when we went to and from the OR, yet the suction tubing hadn’t been changed since the last procedure (no idea when that happened). We learned very quickly, “we were no longer in Kansas”. How we practiced anesthesia was going to be much different than how we were going to practice anesthesia. There were so many things that put us out of our comfort zone. There was one anesthesia ventilator (screen in Spanish), a second anesthesia machine that delivered gas to everyone in the room sans bellows (archaic and incomplete- this would mean the person would have to breath on there own, as even the valve to hand ventilate didn’t work), we had to share the suction with the surgeons alternating who got to use it. Questions were rampant: will the surgeon need paralysis, what’s that stain over there, where did that empty Frappuccino bottle on the suction canister come from? Thankfully, we brought our own monitors for vital signs, although exhaled CO2 monitoring was difficult to achieve and available on one monitor- in percentages.
What we learned from our first mission trip is that we take for granted many of the tools we have at our disposal. Although some of the situations were uncomfortable, according to our standards, we were able to provide safe anesthesia with limited supplies and equipment. Guatemalan children proved to be not only cherubs of cuteness, they were remarkably stoic, and would sit in pre op without their parents, on gurneys with no side-rails, seldom crying, even smiling a bit. Surprisingly, no one fell. Our mission was orthopedic surgery and we did many club foot operations for toddlers. We discovered that if these children could not walk, they could not go to school, without school they would burden their families.
Each night, we laughed about the absurdity of it all and our sincere concerns relating to care we were providing. What happens when we leave, who takes the casts off, hardware out, what about infections, will they be able to walk and then go to school, what about physical therapy, what happens to the kid who traveled 8 hours by bus,..? With so many questions and a better understanding of what we may encounter, we agreed to go again. The group of dedicated healthcare professionals and coordinators from Operation Rainbow made our first experience memorable. Despite all the unknowns and doubts, we met wonderfully resilient people and felt their gratitude, we are planning our next mission.
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AHP Communications Committee
The overarching goal of our committee is to promote efficient and cohesive communication among AHPs across UCSF Health.
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IMPORTANT
Ambulatory AHP 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.
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The date has been announced for the next Medi-Cal SPA Time Study.
June 3-9, 2019
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The following training link provides information that ALL ambulatory AHPs must review to be included. ONLY AHP providers that completed the LMS module will receive a link to the TIME SHEET when the next date is announced.
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The UCSF 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.
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Onica Kuch, NP
Presented on Migraine Pathophysiology and Treatment
CANP Annual Educational Conference
San Diego, CA
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Jessica Brennan, NP
Presented “Intravenous Human Immunoglobulin in combination with immunosuppression reduction for early onset BK viremia in
pediatric kidney transplant patients”
(Pictured on the right with Paul Brakeman, MD and Marylin McEnhill, NP)
Vancouver, BC Canada
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Ada Edwards, NP (not pictured)
Presented on Neuromodulation and Pain Management
CANP Annual Educational Conference
San Diego, CA
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Lissa Gray, NP
Presented at the 48th Annual Meeting of European Society for Blood and Marrow Transplantation
Frankfurt, Germany
We are proud to highlight the new four recipients and their work.
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NEW AMERICAN HEART ASSOCIATION CERTIFICATION WORKFLOW FOR AHP PROVIDERS
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2019 Nursing Week Advanced Practice Award
There were 5 advanced practice (AHPs) recipients:
Susan Woodard, NP
Elizabeth Gundersen, NP
Ann Thibault, NP
Derek Ko, NP
Jennifer Osborn, NP
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UC’s deal with Catholic hospitals threatens the health of women and LGBTQ patients
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An email message from the Chancellor and CEO on May 28th 2019 to all in the UCSF Health community.
Dear Colleagues, Friends, Concerned Citizens:
Over the past several weeks, and in particular at the recent meeting of the UC Board of Regents, we have seen and heard hundreds of thoughtful, principled, and impassioned statements about UCSF’s proposal to expand our relationship with Dignity Health’s four Bay Area hospitals.
Many of you have expressed strong concerns about a significantly expanded UCSF relationship with a health care system that has certain limits on women’s reproductive services, LGBTQ care, and end-of-life options. Meanwhile, many of you have been adamant that UCSF must build on its decades-long affiliation with Dignity Health in order to provide critically needed health care services to our Bay Area communities.
We respect and appreciate the diversity of opinions from multiple stakeholders both within UCSF and outside our University, and we have heard you all. In the past several days, we have met internally, with Dignity Health, and with leaders both in the University of California Office of the President and the Regents. Given the concerns, we will not continue to pursue the affiliation as it had been envisioned, which would have created a stronger link between UCSF Health and Dignity Health’s four Bay Area hospitals.
What remains true is that the critical patient needs that have driven our discussions with Dignity Health still exist, and we have a responsibility to meet them. Going forward, we will continue to work to identify a path to help meet those needs and increase access to crucial health services. We will develop solutions that address many of the concerns we have heard.
We are particularly sensitive to addressing the unique needs of women, LGBTQ patients, and those facing end-of-life decisions, as well as expanding access to welcoming and respectful health care.
Over the last 20 years, UCSF has worked with Dignity Health to advance health care for our communities. We respect the important role that Dignity Health has in our state’s health care system and both recognize and appreciate the quality of care provided by their physicians and caregivers.
We thank you for your continued support for UCSF Health and the important public health mission that we serve.
Sincerely,
Sam Hawgood, MBBS
Chancellor
Mark Laret
President and Chief Executive Officer
UCSF Health
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2019 4th Annual UCSF Health Improvement Symposium
There were over 200 submissions and many highlighted the improvement work of AHPs at UCSF Health including BCH Oakland. I could not include all but here are some photo highlights and the full list will be available for the next newsletter.
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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
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If you would like to be considered for a Clinical Subcommittee please send (1) a letter of interest (not to exceed two pages) highlighting experience/knowledge relevant to the expertise in the subcommittee/episode group and involvement in measure development, and (2) a current CV or summary of relevant experience to Patti Epstein
by April 8, 2019.
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JOIN A NATIONAL CLINICAL SUBCOMMITTEE REPORTING TO CMS
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The American Nurses Association (ANA) is putting out a call for nominations for ANA members to the Centers for Medicare and Medicaid Services (CMS) MACRA Episode-Based Cost Measures. There are four Clinical Subcommittees accepting nominations (listed below along with episode groups as defined by prior workgroups). The overall objective of the committees is to develop episode-based cost measures suitable for potential use in the Quality Payment Program. Applications are requested for the following Clinical Subcommittees.
Nominees should be a clinician including nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, nurse midwives, or other clinicians with experience in the clinical areas listed above. Nominees should also have familiarity with medical coding (ICD-10, CPT/HCPCS, DRG), board-certified or other professional certifications, as applicable, and experience treating Medicare patients. Complete information on the committees and nomination process can be found on the CMS website.
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ADVANCED HEALTH CARE PLANNING FOR PROVIDERS
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Type
.ACP
anywhere in notes or problem lists to assure that your documentation pulls into the
new ACP Navigator.
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GME Grand Rounds - inter-professional opportunity to share experiences.
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AHP NEW HIRES COHORT 8 2019
Please welcome these new AHP professionals
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STARTING ONBOARDING ON APRIL 24TH, 2019
COHORT 8
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Bohn, Nathaniel
Clements, Jessica
Franco, Shannon
Gil, Eugenia
Greenstein, Alexa
Jackson, Kritopher
Jackson, Tamika
Malott, Jocelyn
Mancini, Carrie
Parker, Alice
Pruett, Christina
Recchioni, Cassandra
Ryan, Michelle
Salmon, Rebecca
San Basillo, Monica
Stratford, Shelley
Tomlinson, Starr
Wendland, Barbara
Wong, Chelsea
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THEY ARE A GROUP OF NP AND PA PROVIDERS COMING INTO MANY DIFFERENT CLINICAL SPECIALTIES ACROSS THE UCSF HEALTH ENTERPRISE AND OUR AFFILIATE PARTNERS.
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Get involved in onboarding of new AHP providers through one of the committees recruiting. Socializing after a Cohort Session.
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Seeking AHP Committee Participants that will report to the AHP Advisory Board.
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AHP ADVISORY BOARD MINUTES
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CALIFORNIA HEALTHCARE NEWS
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A COUPLE ARTICLES RELEVANT TO ADVANCED PRATICE. YOU CAN SUBSCRIBE IF YOU WISH.
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Enhancing Relationship Centered Communication Skills Professional Development for Clinicians
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UCSF HEALTH UPDATES REGARDING TRUE NORTH METRICS
Includes an article on price transparency.
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For more information, contact Mitchel Erickson, NP Director of Advanced Practice
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ALL AHP STUDENTS AT UCSF HEALTH FACILITIES
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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.
New Information to come soon to centralize student engagement at UCSF Health.
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WANT TO SHARE YOUR EXPERTISE WITH AHP COLLEAGUES ACROSS THE STATE, THE NATION, OR THE WORLD?
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MORE INFORMATION AND TO BE A PEER SUPPORTER, EMAIL THE FOLLOWING LINK.
Other Resources
:
1.
Mindfulness Mediation
2.
Gratitude Mediation
3.
Loving Kindness Meditation
4.
1-Minute Meditation (for the super-busy)
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Are you a Clinical Preceptor?
Are you interested in precepting or becoming volunteer clinical faculty?
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Presentations, Publications, Recognitions, and News
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The following AHP providers were recipients of Nurse's Week Awards
Cardiology - Susan Woodard, NP Cardiac Stress Lab
Advanced Practice Award - Dereck, Ko, NP, BMT/HemOnc
Advanced Practice Award - Jennifer Osborn, NP FNP Primary Care
Anne Thibault, NP Care Support Program
Elizabeth Gundersen, NP ICU Community Volunteer Service
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Jessica Brennan, Paul Brakeman, Shanthi Balani (2
nd yr peds fellow)
Our poster is titled “
Rick factors for early readmission post-pediatric kidney transplantation.”
This poster was accepted and presented at the ASN meeting in November 2018.
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Publication: Ana Marie Torres, NP UCSF Transplant Division
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“Bi-organ Paired Exchange – Sentinel Case of a Liver-Kidney Swap”
American Journal of Transplantation
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Article published in
Patient Experience Journal
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Representing UCSF Health at ACP this year in Philadelphia, PA
She plans to create a group for AHPs next year.
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Laura Kirk, PA and Trina Sheedy, PA and Regina Gould, PA at
The Society of PAs in Otorhinolaryngology (SPAO)
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CME meeting for 2019, “ENT for the PA-C” was led by course director Laura Kirk, PA-C. The course welcomed 450 PA, NP, and MD participants from across the nation who engaged in 1 day of workshops and a 3 day lecture series. Workshops were directed by Trina Sheedy, PA-C. Trina led a workshop on Diagnostic H&N Ultrasound, while Regina and Laura served as proctors in Epistaxis and Vertigo workshops, respectively.
They were speakers lecturing on “Tracheostomy Best Practices Using Interdisciplinary Teams,” Trina Sheedy delivered a keynote session on “HPV Above the Waist: a Head & Neck Cancer Epidemic,” and Laura Kirk delivered a keynote session “Enhancing Communication to Reduce Errors” in collaboration with Dr Jo Shapiro from Harvard University and Brigham and Women’s Hospital.
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Publication:
Novel NS5B Resistance‐Associated Substitution Emerges Under Failing Sofosbuvir/Ledipasvir Therapy
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Jay Hunter, PNP and Faculty in the UCSF School of Nursing
National Association of Pediatric Nurse Practitioners 40th National Conference on Pediatric Health Care, New Orleans, LA
March 2019
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Workshop presentation: Danford, C. A., Heuer, B., Hunter, J. M., Reyes, I., & Spruit, J. L. (2019, March). The art of precepting: Practical tips for a successful pediatric precepting experience.
Podium presentation: Hunter, J. M., & Panton, J. L. (2019, March). Evidence-based utilization of diagnostic imaging in pediatric patients.
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Contributing author: Position Statement on Age Parameters for Pediatric Nurse Practitioner Practice for the National Association of Pediatric Nurse Practitioners (https://www.jpedhc.org/article/S0891-5245(18)30580-7/pdf):
Heuer, B., Hunter, J. M., Hatton, A., Lee, A., Lofgren, M., Reyes, I., & Keesing, H. (2019). NAPNAP position statement on age parameters for pediatric nurse practitioner practice.
Journal of Pediatric Health Care, 33, A9-A11. doi: 10.1016/j.pedhc.2018.10.007
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One Good Thing
Improving the Work Experience at UCSF
Issue 57
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.
Sustainability at University of California
Healthcare accounts for 10 % of U. S. Green House Gas Emissions (GHGs), equal to that produced by the entire United Kingdom. The impact of climate change and healthcare's role are described in this recent NEJM article
The Imperative for Climate Action to Protect Health.
I interviewed Gail Lee, Director of Sustainability at UCSF, to learn how UC is leading in this space. In 2015, UC President Napolitano and California Governor Jerry Brown attended the Paris Climate Action Summit, after which UC became the first university in the country to commit to going carbon neutral by 2025. That's a pretty tall order.
The UC strategy to get to zero emissions includes converting to clean energy support, currently including:
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a 680 megawatt solar farm in the desert south of Fresno
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solar panels added to all UC buildings that will support them
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the San Francisco
hetch hetchy
system (100% greenhouse gas-free hydroelectric power)
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2 biogas projects (capturing and reusing methane from sources like landfill and animal waste)
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Converting the fleet of shuttles to electric vehicles
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and many, many more...
Seema Gandhi, MD, in the Department of Anesthesiology, has helped to lead the way with projects like reduction of the most environmentally harmful anesthetic gases (i.e. desflurane), and the perioperative group as a whole is working to decrease single use devices.
The UCSF Academic Senate recently voted on a
memorial
to the University of California regents urging UC to divest its endowment portfolio ($10.4 billion) of all investments in 200 publicly traded fossil fuel companies with the largest carbon reserves. Read more
here
.
We can all help by turning off equipment when not in use and choosing "Energy Star" appliances where available, among many other
ways we can help
.
On a personal note, when I needed to buy a new car this year, I finally took the plunge and went electric. My experience has been amazing-I highly recommend it. Commuting contributes 14% to UCSF's carbon footprint!
In addition, it feels pretty amazing to work for an organization that is taking climate change and sustainability so seriously. Thanks to all of the leaders and individuals who have committed to making an impact.
Past Issues
Submit a One Good Thing Idea to
Diane Sliwka, MD
, Chief Physician Experience Officer at UCSF Health.
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RESOURSE INFORMATION AND LINKS
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UCSF EMPLOYEE DISCOUNTS AND BENEFITS FOR WORK, LIFE, AND FAMILY
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
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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.
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2018/2019 AHP ADVISORY BOARD
Feel free to reach out to them through global Outlook
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Alisa Yee, NP
Willie Ching, CRNA
Shelley Gierat, CRNA
Jeremy Graham, NP
Jennifer Kerney, NP
Laura Kirk, PA - Chair
Maura O’Day, NP
Brandon Sessler, PA
Stacy Wong, NP
Eliana Agudelo, PA
Dana Morgan, PA
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Laura Weil, CNM
Annette Carley, NP
Gerri Collins Bride, NP
Tracy Curtis, PA
Mitch Erickson, NP
Lissa Gray, NP- Co-chair
Rebekah Kaplan, CNM
Danielle Krieger, NP
Tara Valcarcel, NP
Stacie Rohovit, NP
Michelle Klosterman, NP
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Check for any Required Training
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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)
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FACE CARDS FOR AHP 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 the RCL or use the RCL photo stock. If you want to use the RCL photo stock. To retrieve a photo taken by RCL, please contact the email below with your name and purpose of use. State for UCSF provider Face Cards.
webservices@ucsfmedctr.org
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Making yourself more visible at UCSF Health
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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.
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This link will bring you to the UC ME login page. Use the button on the far left at the bottom to access the AHP Resource Manual.
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This can be completed at the UC Me page by clicking on REQUEST NEW PRIVILEGE.
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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:
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.
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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.
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If you have any suggestions regarding content or additions to the monthly newsletter, please send them to: (submission deadline is 1st of each month)
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