CELEBRATING PROFESSIONAL

NURSE PRACTITIONERS

NURSE ANESTHETISTS

PHYSICIAN ASSISTANTS

NURSE MIDWIVES 

IN THIS ISSUE

Highlighting AHP Practice at UCSF Health

Article by Laura Quill, PNP regarding ACE in Pediatrics



AHP UPDATES

Exceptional AHP Award Nominees and Recipients

Informed Consent Policy

Highlights of the UCSF SON DNP Program

Open Forum Highlights

NP3 Promotions

NPS Data Sharing

Inpatient Documentation Workflow and Workflow Compliance

AHP Academic Stipend

BRN Important Updates

Michelle Klosterman and Jason Wong Story

Medi-Cal SPA Time Study for Ambulatory Providers

AHP Communication Committee and UCSF AHP Chatter Instructions

New AHP AHA Re-Certification Workflow

Schwartz Rounds

Burnout in Health Care

GME Grand Rounds

New AHPs to UCSF Health for the 9th Cohort in 2019

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

Danielle Krieger, NP

Eliana Agudelo, PA

Claudia Praglin, NP

Maura, O;Day, NP

Anna Marie Torres, NP

Mitchel Erickson, NP

Marilyn McEnhill PNP

Giulia Worner NP

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

Article by: Laura Quill, PNP

UCSF HEALTH AHP COMMUNICATIONS COMMITTEE

Our goal is to promote efficient and cohesive communication among AHP's across UCSF Health. AHP's are encouraged to join the "UCSF AHPs" Chatter group in effort to better facilitate sharing of information and connect with other AHPs. Please see the instructions so you don't miss this opportunity to keep up with other AHPs at UCSF Health.

FOR THOSE WITHOUT ACCESS TO NY TIMES

You are at your daughter’s recital and you get a call that your elderly patient’s son needs to talk to you urgently. A colleague has a family emergency and the hospital needs you to work a double shift. Your patient’s M.R.I. isn’t covered and the only option is for you to call the insurance company and argue it out. You’re only allotted 15 minutes for a visit, but your patient’s medical needs require 45. These quandaries are standard issue for doctors and nurses. Luckily, the response is usually standard issue as well: An overwhelming majority do the right thing for their patients, even at a high personal cost. It is true that health care has become corporatized to an almost unrecognizable degree. But it is also true that most clinicians remain committed to the ethics that brought them into the field in the first place. This makes the hospital an inspiring place to work. Increasingly, though, I’ve come to the uncomfortable realization that this ethic that I hold so dear is being cynically manipulated. By now, corporate medicine has milked just about all the “efficiency” it can out of the system. With mergers and streamlining, it has pushed the productivity numbers about as far as they can go. But one resource that seems endless — and free — is the professional ethic of medical staff members. This ethic holds the entire enterprise together. If doctors and nurses clocked out when their paid hours were finished, the effect on patients would be calamitous. Doctors and nurses know this, which is why they don’t shirk. The system knows it, too, and takes advantage. The demands on medical professionals have escalated relentlessly in the past few decades, without a commensurate expansion of time and resources. For starters, patients are sicker these days. The medical complexity per patient — the number and severity of chronic conditions — has steadily increased, meaning that medical encounters are becoming ever more involved. They typically include more illnesses to treat, more medications to administer, more complications to handle — all in the same-length office or hospital visit. By far the biggest culprit of the mushrooming workload is the electronic medical record, or E.M.R. It has burrowed its tentacles into every aspect of the health care system. There are many salutary aspects of the E.M.R., and no one wants to go back to the old days of chasing down lost charts and deciphering inscrutable handwriting. But the data entry is mind-numbing and voluminous. Primary-care doctors spend nearly two hours typing into the E.M.R. for every one hour of direct patient care. Most of us are now putting in hours of additional time each day for the same number of patients. In a factory, if 30 percent more items were suddenly dropped onto an assembly line, the process would grind to a halt. Imagine a plumber or a lawyer doing 30 percent more work without billing for it. But in health care there is a wondrous elasticity — you can keep adding work and magically it all somehow gets done. The nurse won’t take a lunch break if the ward is short of staff members. The doctor will “squeeze in” the extra patients. The E.M.R. is now “conveniently available” to log into from home. Many of my colleagues devote their weekends and evenings to the spillover work. They feel they can’t sign off until they’ve documented all the critical details of their patients’ complex medical histories, followed up on all the test results, sorted out all the medication inconsistencies, and responded to all the calls and messages from patients. This does not even include the hours of compliance modules, annual mandates and administrative requirements that they are expected to complete “between patients.” For most doctors and nurses, it is unthinkable to walk away without completing your work because dropping the ball could endanger your patients. I stop short of accusing the system of drawing up a premeditated business plan to manipulate medical professionalism into free labor. Rather, I see it as a result of administrative creep. One additional task after another is piled onto the clinical staff members, who can’t — and won’t — say no. Patients keep getting their medications and their surgeries and their office visits. From an administrative perspective, all seems to be purring along just fine. But it’s not fine. This month the World Health Organization recognized the serious effects of burnout from chronic workplace stress. Burnout levels among doctors are at new highs, far worse than among the general population, and increasing relentlessly. Burnout among nurses is similarly rising and is highest among those on the front line of patient care. Doctors and nurses commit suicide at higher rates than in almost any other profession. Higher levels of burnout are also associated with more medical errors and compromised patient safety. This status quo is not sustainable — not for medical professionals and not for our patients. Mission statements for health care systems and hospitals are replete with terms like “excellence,” “high-quality” and “commitment.” While these may sound like Madison Avenue buzzwords on a slick brochure, they represent the core values of the people who labor in these institutions. Health care is by no means perfect, but what good exists is because of individuals who strive to do the right thing. It is this very ethic that is being exploited every day to keep the enterprise afloat. The health care system needs to be restructured to reflect the realities of patient care. From 1975 to 2010, the number of health care administrators increased 3,200 percent. There are now roughly 10 administrators for every doctor. If we converted even half of those salary lines to additional nurses and doctors, we might have enough clinical staff members to handle the work. Health care is about taking care of patients, not paperwork. Those at the top need to think about the ramifications of their decisions. Counting on nurses and doctors to suck it up because you know they won’t walk away from their patients is not just bad strategy. It’s bad medicine. 

American Transplant Congress (ATC) in Boston 2019

UCSF Health AHPs were there representing the UCSF Transplant Program and Advance Health Providers.

Danielle Krieger NP is in a leadership role with the American Society of Transplantation community of practice for advanced practice providers (NPs and PAs). Danielle moderated one of the session at ATC and helped to lead the Transplant Advanced Practice Providers general meeting. Claudia Praglin NP and Eliana Agudelo PA collaborated with Drs. A. Chen and G. Roll in a poster titled “Nodular Regenerative Hyperplasia After Liver Transplant – It is All in the Presentation”. There was time for learning, team bonding, and for planning more projects to continue to represent UCSF Transplant Services and to increase AHP practice and presence at our national meetings.

Pictured also:

Marilyn McEnhill PNP Kidney Transplant and

Giulia Worner NP Pancreas Transplant  

One Good Thing

Improving the Work Experience at UCSF

Issue 66

Compliments of Diane Sliwka, MD

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.

How To Develop As a Leader

Many physicians find themselves in leadership positions without formal leadership training. Even without formal authority, others are looked to as great leaders. We all want things to work better around us, and if we are going to help make that happen, what can we learn from what great leaders do?

In her book Dare to Lead, Brene Brown defines a leader as:

"Someone who takes responsibility for finding the potential in people and processes, and who has the courage to develop that potential.”

Below are some tips from the article: How to Be an Effective Physician Leader: Strategies for Those With Formal or Informal Authority by Shikha Jain, MD, FACP

·     Build interpersonal relationships within your group and between otherwise disconnected groups

·     Develop a limitless vision

·     Build relationships with supporters, skeptics and those "on the fence"

·     Surround yourself with diverse people

·     Work on your own Emotional Intelligence (Self Awareness, Empathy, Introspection)

·     Make those who work with you feel valued

Additional Resources:

Article about Daring Leadership by Brene Brown

One Good Thing Issue 14: Leader Behaviors that Support People

Thanks to all of you "leaders" who don't throw your hands up when things are hard, but rather see what is possible and work toward that limitless vision. That is one of the things that makes UCSF such an amazing place to work, for me.

Thanks also to Catherine Lucey, whose tweet about leadership inspired this One Good Thing.

2018/2019 AHP ADVISORY BOARD

Feel free to reach out to them through global Outlook

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. 

UCSF Directory

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)

mitchel.erickson@ucsf.edu