UCSF Center for Healthcare Value - Caring Wisely 2.0

Crowd-sourcing innovative cost savings ideas from the front lines of care delivery systems

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The UCSF Center for Healthcare Value (CHV) called for the best ideas to reduce inefficiencies and health care costs as Phase 1 of the Caring Wisely initiative. The top 10 ideas at each site were selected as "Hot Spots" for Phase 2, which will be a call for proposals from within the UCSF and SFGH communities to address the areas of interest identified from the winning ideas in Phase 1.

Ideas (172 total)

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Generating more revenue for SFGH

Submitted by Thearith Seng on February 6, 2014 - 11:52pm Last revised by Web Producer on March 13, 2014 - 12:43pm.
Idea Status: 
Review Complete

Inpatient resident documentation on admission H&Ps, daily progress notes and discharge summaries is intimately tied to how SFGH, a publically funded safety net hospital that provides 20% of all inpatient admissions to the city, is reimbursed. More specific diagnoses are coded to heavier weighted drgs that lead to higher reimbursements. For example, there is a difference of thousands between simply writing congestive heart failure and acute on chronic systolic heart failure.

Communicating Wisely for Care Transitions

Submitted by Jordan Chase on February 6, 2014 - 8:55pm Last revised by Web Producer on March 13, 2014 - 12:43pm.
Idea Status: 
Review Complete
Care transitons is a critical focus in cost containment.  
 
We propose an email-based discharge communication process to identify multidisciplinary needs on admission of an inpatient, and communicate these simultaneously to multiple multidisciplinary providers in the primary care medical home and ancillary clinics.

Re: Prevent Pressure Ulcers

Submitted by Katherine Padaoan on February 6, 2014 - 5:48pm Last revised by Web Producer on March 13, 2014 - 12:43pm.
Idea Status: 
Review Complete

To ensure that patients who are high risk for pressure ulcers are turned every 2 hours, place a sign above bed to remind staff to turn patient on the even hours. The sign would have a clock with the even hours and also a stick figure of which side to turn the patient. Also, to ensure staff safety, have PCA's or RN's be assigned to go through the floor and turn ALL patients on the even hours to a) increase teamwork and b) decrease staff injuries.

UCSF MD's to Receive Regular Psychological-Emotional Support Services as Part of the Progression of Self-Care in Medicine

Submitted by Freya Magnusson on February 6, 2014 - 5:04pm Last revised by Web Producer on March 13, 2014 - 12:43pm.
Idea Status: 
Review Complete

So, this is ANYTHING but a new idea, but I'm proposing it again at this time in UCSF's history.  As medicine continues to evolve as a delivery care system, as our financial and work stresses increase, and as the expectation continually tends to focus on doing more in less time, the need for regular therapy for our physicans as a support system of self-care for them to undertake these challenges rises in urgency. 

 

Hip Fracture Care Pathway

Submitted by Lawrence Haber on February 6, 2014 - 3:29pm Last revised by Web Producer on March 13, 2014 - 12:43pm.
Idea Status: 
Review Complete

Hip fracutres are a common admission to both the orthopedic and IM/ FM services at San Francisco General Hospital. Good evedence exists behind the value of standard practices and pathways to ensure efficient and evidence-based care of these patients. Currently no standardized approach to hip fracture patients exists at SFGH.

Decrease Paper Use in the Clinical Laboratory

Submitted by Kathleen Kushner on February 6, 2014 - 1:45pm Last revised by Web Producer on March 13, 2014 - 12:43pm.
Idea Status: 
Review Complete

Some instruments in the UCSF Clinical Laboratory are set to automatically print test results on computer paper. Most of these instrument printouts are then put in a Cintas Document Management Security Container to be shredded.  I propose that the instruments'automatic printing be turned off and only those hard copies which are necessary be printed. This would save paper and shredding costs. I have already done this with our coagulation instruments.

Improving/Maximizing use of RN Blood Pressure Checks in the Family Health Center

Submitted by Leslie Lane on February 6, 2014 - 10:36am Last revised by Web Producer on March 13, 2014 - 12:43pm.
Idea Status: 
Review Complete

Currently in the Family Health Center, RN visits are available to use for blood pressure checks and medication titration, however there is no standardized process for these visits and no standardized way for providers to communicate to the RNs their instructions for the visit, and no standardized way for RNs to record/communicate the outcome of the visit. Some providers are not aware that these visits are available, and other providers have not had success using them.

Decrease duplicate Type&Screen or Check Specimen in the OR

Submitted by Jocelyn Chapman on February 6, 2014 - 10:33am Last revised by Web Producer on March 13, 2014 - 12:43pm.
Idea Status: 
Review Complete

Patients get a check specimen drawn in the OR at the time of IV access.  The check specimen is often a duplicated test as the blood bank only requires a historical Type and Cross and a current type and Cross in order to crossmatch blood.  

 

We propose that the duplicate test happens because staff (a.) do not understand what the check specimen is for and (b.) do not know that a historical type and screen and a current type and screen preclude the requirement for this test. 

 

 

 

 

Code Blue Light Covers

Submitted by Daniel Gordon on February 6, 2014 - 10:26am Last revised by Web Producer on March 13, 2014 - 12:43pm.
Idea Status: 
Review Complete

Add a cover to the code blue / staff assist lights in each patient room. This will prevent visitors and cleaning staff from inadvertently initiating a Code Blue. When a Code Blue is called there is significant mobilization of resources and increase in staff and visitor stress levels. Preventing false alarms would save resources by preventing the Code Team from having to drop what they're doing in order to respond. This would also improve productivity as a false Code Blue is stressful and disrupts the work flow of everyone involved.

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