October 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 inaugural FY19 scorecard, both visually and with specific metrics.
What's new visually on the scorecard?

We've made a few enhancements based on your feedback:

1. Trend lines: for a number of key metrics (e.g., mortality, sepsis, readmissions, LOS), we've created a 9-month trend line that provides a broader view of how a given month's performance fits into recent performance. A green dot on the trend line denotes the best month's performance and a red dot the worst; the dotted line represents our aspirational 90th percentile benchmark to other academic medical centers. 

2. Actual #s: similar to our approach with harm events, we've added patient numbers to our mortality, sepsis, and readmission data. For instance, during the month of July, you'll note that our Mortality O/E was exceptional at 0.83; this translates to 59 actual deaths with 31 from sepsis (a typical month for us). We also had a near record low month for readmissions at 10.28%, which equates to 318 actual patients. We hope the combination of an index with patient numbers tells a better story.

3. Static versus dynamic data: with the exception of the People pillar, all of the other metrics are dynamic and get updated monthly. To make this clearer, we've oriented the Gallup and Net Promoter data differently and now provide a 3-year trend to each.
What metrics are new (or changed) on the scorecard?

 Over the past couple months, our improvement teams were asked to reflect on our current True North metrics and related improvement work. The goal was to assure we're still focused on the right metrics. This follows the adage "you focus on what you measure"-- so let's make sure we're focusing on the right things. A couple highlights of the changes for the year ahead:

1. Ambulatory Quality: rather than highlighting a roll-up of metrics as we did in FY18, we've chosen to focus on Advanced Care Planning and a Health Equity metric for FY19. The former is incredibly important with our aging population and continued desire to provide patient-centered care. The latter reflects an emerging set of priorities focused on achieving health equity, which builds on a recent UCSF Health retreat (see below). The scorecard highlights our current performance in BP control among our Black/African-American patients given the disparity compared to other populations. We look forward to sharing more about both efforts in future newsletters.

2. Harm Events: we've redefined our harm events for pressure ulcers and falls to better align them with what our nursing colleagues see on a regular basis. While the new definitions broaden the harm events for the scorecard (resetting the FY18 baseline to a higher number), it provides the opportunity to more consistently share the same data to the improvement teams and providers focused on reducing our pressure ulcers and falls.
News and Announcements
CURES Mandate is Here!
The mandate to consult CURES prior to prescribing schedule II-IV controlled substances will became effective October 2, 2018. By now, you should have received an email communication that describes the mandate and our UCSF Health Best Practice Alert solution in APeX. If you prescribe schedule II-IV controlled substances in your practice or at discharge from the hospital setting, please make sure your CURES registration is active on their website . For additional information on the mandate, please review a recently published FAQ .
Recap from the 3rd Annual UCSF Health Improvement Retreat
On September 21st, we hosted our annual leadership retreat where we focused on Health Equity. Our day started with a very compelling patient panel who described their challenges in receiving care that stemmed from their race, sexual orientation, disability and/or lack of interpretation services from speaking non-English as a primary language. Alicia Fernandez , one of our UCSF faculty and a national expert in healthcare disparities, delivered a keynote presentation to share national frameworks and quality improvement approaches to reducing disparities . This was followed by sharing examples from UCSF Health of our own disparities in patient experience and quality metrics, such as HTN. The day continued with a leadership panel comprised of Josh Adler, Sheila Antrum, Talmadge King, Julie Ann Sosa (moderated by Kevin Grumbach) who shared their perspectives on why this work is so important and requires greater attention moving forward. Finally, we had engaging table discussions that helped inform the UCSF Health Equity Council of how to strategically move key initiatives forward. We look forward to sharing more about these efforts soon.
Schwartz Rounds
This month's Schwartz Rounds will take place on October 9th at Parnassus, HSW-301, and will feature " Coping with the Moral Distress of Health Inequity" ; 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.