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White coat ceremony launches UC Riverside School of Medicine

Inaugural class of 50 students begins a pioneering journey.

An admiring crowd of 700 people cheered on the inaugural class of 50 students in UC Riverside’s School of Medicine on Friday (Aug. 9). Each student slipped into the doctor’s white coat, held by a faculty member, to mark the beginning of four years of hard work.

The live string quartet, floral arrangements, beautiful programs and colorful lights are not typical for UCR’s Student Recreation Center — the home court of UCR basketball — but the campus needed its biggest room to fit the students, the families, the faculty and all the community supporters of this new kind of medical school, designed to increase the supply of primary care doctors practicing in the Inland Empire.

Laura Wilson is congratulated by a fellow student after receiving her white coat. (Photo by Carrie Rosema)

Laura Wilson is congratulated by a fellow student after receiving her white coat.

“I’ve been telling the students this is a once in a lifetime event, like the sighting of Haley’s comet, said Kendrick A. Davis, director of medical education for the UCR School of Medicine. “It is rare that you are in the right spot and you can take advantage of it. It is beyond a milestone. You are talking about embarking on something that hasn’t really been done, the way that we are doing it,” he said. “Every person involved in this is a pioneer, so you have to be excited about it, and be willing to put in all the work to make this successful.”

The mission of the UCR School of Medicine is to improve the health of the Inland Empire by producing culturally diverse primary care doctors who will stay and practice medicine in the area, which has a chronic shortage of doctors. UCR has had the first part of a medical school program for more than 30 years, but the students always finished their work at other medical schools, including UCLA. Now medical school students can stay to finish their M.D. UCR is also developing residency training programs in partnership with regional hospitals.

The effort to establish the school took a concerted community effort over many years, capped off recently with a state budget deal that included $15 million in annual funding, thanks to the successful advocacy of the Inland Empire Caucus, the Monday Morning Group and Inland Action. This is UC’s sixth medical school and California’s first new public medical school in four decades.

“We are at the end of a long relay,” said Dr. G. Richard Olds, the founding dean of the School of Medicine. “Each time we had a roadblock, our community doubled down on their effort. I want to thank everyone for that effort.”

Five people earned honorary white coats for the heavy lifting in the last stretch of a 10-year long relay race:  State Sen. Richard Roth; Assemblymember Jose Medina; interim Chancellor Jane Close Conoley; and two leaders from the University of California Office of the President, Dan Dooley and Patrick Lenz.

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UC hospitals rank among best in U.S.

U.S. News ranks UC medical centers highly.

Patient care at UC Davis Medical CenterThe University of California again has the West’s top two hospitals and all five of its medical centers rank among the nation’s best hospitals, according to U.S. News & World Report’s annual survey.

U.S. News also ranked UC medical centers No. 1 in their metropolitan areas – Ronald Reagan UCLA Medical Center in Los Angeles, UCSF Medical Center in San Francisco, UC San Diego Health System in San Diego  and UC Davis Medical Center in Sacramento. UC Irvine Medical Center ranked best in Orange County and fourth in the Los Angeles region.

For the 2013-14 America’s Best Hospitals survey, U.S. News evaluated about 5,000 hospitals nationwide in 16 adult specialties, reviewing patient safety, reputation and other factors, with just 147 ranking nationally in even one specialty. Ronald Reagan UCLA Medical Center and UCSF Medical Center were among two of only 18 hospitals that entered the honor roll by scoring high in at least six specialties.

“A hospital that emerges from our analysis as one of the best has much to be proud of,” said Avery Comarow, U.S. News’ health rankings editor. “Only about 15 percent of hospitals are recognized for their high performance as among their region’s best. Just 3 percent of all hospitals earn a national ranking in any specialty.”

Ronald Reagan UCLA Medical Center ranked fifth nationally and was best in the western United States for the 24th consecutive year. UCLA ranked among the top 50 hospitals nationally in 15 of the 16 specialties: cancer (11); cardiology and heart surgery (17); diabetes and endocrinology (13); ear, nose and throat (11); gastroenterology and GI surgery (8); geriatrics (3); gynecology (38); nephrology (8); neurology and neurosurgery (9); ophthalmology (5); orthopedics (19); psychiatry (9); pulmonology (24); rheumatology (8); and urology (4).

UCSF Medical Center ranked seventh nationally. UCSF placed among the top 50 hospitals nationally in 13 specialties: cancer (7); diabetes and endocrinology (5); ear, nose and throat (12); gasteroenterology and GI surgery (27); geriatrics (8); gynecology (8); nephrology (7); neurology and neurosurgery (5); ophthalmology (14); orthopedics (14); pulmonology (24); rheumatology (10); and urology (7).

UC San Diego Health System ranked among the top 50 hospitals nationally in 10 specialties: cancer (42); cardiology and heart surgery (42); diabetes and endocrinology (29); ear, nose and throat (48); gastroenterology and GI surgery (31); geriatrics (20); nephrology (17); neurology and neurosurgery (42); pulmonology (9); and urology (22).

UC Irvine Medical Center, which made the Best Hospitals list for the 13th consecutive year, ranked in three specialties: geriatrics (30), nephrology (47) and urology (48).

UC Davis Medical Center is ranked nationally in pediatric orthopedics and high-performing in 12 adult specialties: cancer; cardiology and heart surgery; diabetes and endocrinology; ear, nose and throat; gastroenterology and GI surgery, geriatrics; gynecology; nephrology; neurology and neurosurgery; orthopedics; pulmonology; and urology.

Survey results are available online at http://health.usnews.com/best-hospitals. Overall, Johns Hopkins Hospital in Baltimore ranked first; Massachusetts General Hospital in Boston was second; the Mayo Clinic in Rochester, Minn., was third; and the Cleveland Clinic was fourth.

Related links:

See also:
UC children’s hospitals rank among nation’s best

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SF General Hospital’s trauma unit responds to region’s biggest disasters

Care for Asiana plane crash victims reflects strong UCSF-SFGH collaboration.

A nurse screens an incoming patient in the Emergency Department of San Francisco General Hospital and Trauma Center. (Photo by Susan Merrell, UC San Francisco)

A nurse screens an incoming patient in the Emergency Department of San Francisco General Hospital and Trauma Center.

Geoff Manley, M.D., Ph.D., was heading to a meeting at San Francisco General Hospital and Trauma Center (SFGH) last week when he heard something on the radio about a plane crash at San Francisco International Airport.

Initial news reports were unclear about the severity of the accident and the number injured, but Manley, SFGH’s chief of neurosurgery and an internationally recognized expert in brain trauma, knew one thing: he needed to step on the gas and go to the hospital immediately.

“In trauma care, we must always be prepared to deal with situations as they come and conditions in which lives are won and lost within hours or minutes,” said Manley, who like all physicians at SFGH holds dual appointments with the hospital and UC San Francisco, where he’s a professor of neurosurgery.

By the time he got there, the first wave of patients – with some of the most serious injuries – was arriving at the public hospital, the only Level 1 Trauma Center for the city and county of San Francisco and northern San Mateo County.

Over the next six-and-a-half hours on July 6, three more waves of patients would follow, with conditions ranging from road rash and fractures to spinal cord and brain injuries, from the crash of Asiana Airlines Flight 214.

“I’ve been involved in many other multiple injury events, and yet when you hear that 25 ambulances are en route to your hospital, it’s a pretty ominous thing,” Manley said. “We didn’t know what we were going to see.”

Chris Barton, M.D., SFGH chief of emergency medicine, recalls constantly circulating in the Emergency Department to check and recheck that they were staffed appropriately and had all the resources they needed.

“Your initial reaction to an accident of this magnitude is ‘Are we going to be able to handle that many patients?’ But we train for this. We do drills, and everyone knew what their role was,” said Barton, a clinical professor at UCSF. “At SFGH, we have a certain sense of mission that affects everything we do, and that was reflected in our response to this accident. No matter what people asked for, our first answer was, ‘Yes, we’ll make that happen.’”

In all, the SFGH team cared for 67 patients who survived the plane crash, including 36 adults and 31 children. Most have since been discharged, but as of Friday morning, seven remained hospitalized, including three in critical condition.

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Governor signs budget that brings UC Riverside medical school state funding

UC system to allocate $15 million annually to med school from its budget.

The UC Riverside School of Medicine Research Building

A budget compromise worked out and signed today by Gov. Jerry Brown means that UC Riverside’s School of Medicine will receive full and continuous funding of $15 million per year — long-sought assistance that enables the school to flourish and greatly facilitates its ongoing accreditation.

The $15 million for the UCR medical school was included in the 2013-14 state budget and budget trailer bills adopted by the California state Legislature on June 14 and 15. The budget provides for an increase in the University of California base budget of $125.1 million for the new fiscal year, along with approval for UC to restructure its bond debt, generating an estimated $80 million annually for the next decade. Funding for the UCR medical school will now be part of UC’s base budget annually going forward.

The agreement triggered celebration on campus and in the surrounding community.

“The creation and development of the medical school has been the vision of many at UC Riverside and in our community for many years,” said UC Riverside interim Chancellor Jane Close Conoley.  “Today we reached a milestone for the health of our region and the future of UCR.”

She said the leadership of Senator Richard D. Roth, D-Riverside, and Assemblymember Jose Medina, D-Riverside, was critical to funding the UC Riverside School of Medicine.  Both campaigned on getting on-going funding for the medical school, and after election both immediately introduced legislation to that effect.

Roth called the $15 million of ongoing state money in this year’s state budget a victory for the medical school, the health of the people of Inland Southern California, as well as the regional economy. “This victory will benefit all of us today and our families for generations to come,” he said.

Medina said the Legislature took a major step forward to meet the area’s need for doctors and healthcare providers.  “The UC Riverside medical school will also advance the economic competitiveness of the region, bringing much needed jobs within the health related fields,” he said.

“Without their leadership, without their efforts elevating this as a budget priority, it would not have been successful,” said Patrick Lenz, the UC’s vice president for budget, and one of the chief architects of the agreement.

The UC Riverside School of Medicine will enroll an inaugural class of 50 students this August, and is the first medical school to be developed in California in more than 40 years.

Establishment of the UCR School of Medicine was approved by the UC Board of Regents in July 2008. G. Richard Olds, the school’s founding dean and the vice chancellor for health affairs, was appointed in February 2010, and the school received preliminary accreditation from the Liaison Committee on Medical Education in October 2012. Two UCR buildings are completed — the new School of Medicine Research Building and the renovated School of Medicine Education Building — and faculty and staff have been preparing for several years for the official opening on Friday, Aug. 9.

“We would not have reached this point without Assemblymember Medina and Senator Roth’s tireless efforts to champion our new medical school and secure in the Legislature’s budget full and continuous funding,” Olds said.  “We can now start addressing one of the most severe shortages of primary care physicians in the nation.”

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Related link:
Governor signs 2013-14 budget

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UC Health launches Flipboard magazine

Readers can download free app to view on tablets and smartphones.

A new digital magazine for tablets and mobile devices puts information about UC Health’s latest ideas and innovations at users’ fingertips.

Readers can view the UC Health Flipboard magazine by downloading the free Flipboard app to their tablet or smartphone, and then searching for UC Health. The magazine is an offshoot of UC’s first systemwide Flipboard magazine, Fiat Lux, which launched June 1 to highlight the university’s latest discoveries and insights.

“We are always looking for new ways to help Californians understand and appreciate the public value that UC brings to the state and the world,” said Jason Simon, executive director of marketing and communications for the UC Office of the President. “A digital magazine lets us reach important audiences where they are – on their mobile devices – and offers them an easy and engaging way to keep up with the latest and greatest from across the UC system.”

The UC Health magazine already has drawn more than 10,000 page flips in its first month.

Flipboard works on both Apple iOS and Google Android devices for phone or tablet. Download it at http://flip.it/D4znS.

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Guidelines help doctors answer question: ‘How long do I have to live?’

Clinicians can use framework in communicating uncertain prognoses.

“How long do I have to live?” is a question senior citizens and those battling terminal illness often ask their doctors.

Now, a UC San Francisco-led team of physicians publishing in today’s (June 26) New England Journal of Medicine have created a set of guidelines for doctors and other clinicians to use for communicating uncertain prognoses to patients.

Prognosis – the science of predicting how long a patient will live – can be a complex undertaking because uncertainty is an inherent part of predicting medical outcomes.

Alexander Smith, UC San Francisco

“It used to be that making a prognosis was a fundamental part of what we did, and that’s waned over time as we’ve focused more on diagnosis and treatment,” said senior author Alexander K. Smith, M.D., M.P.H., assistant professor of medicine in the UCSF Division of Geriatrics. “But providing a prognosis is still an essential part of what we do. Patients ask about it. It is important for nearly every medical decision in older adults.” (See an earlier video with Smith about assessing life expectancy of older patients.)

Smith and his colleagues at University of Pittsburgh assessed what clinicians’ responsibility should be for providing a prognosis. “On the one hand,” he said, “they should not use uncertainty as an excuse to avoid the conversation entirely.  On the other hand, how should they help patients deal with uncertain information, given that uncertainty tends to produce so much anxiety in patients?”

The co-authors developed several guidelines for clinicians to use in addressing the issue with patients.

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Berkeley Lab confirms thirdhand smoke causes DNA damage

UCLA, UCSF scientists collaborate on study.

A study led by researchers from Lawrence Berkeley National Laboratory has found for the first time that thirdhand smoke — the noxious residue that clings to virtually all surfaces long after the secondhand smoke from a cigarette has cleared out — causes significant genetic damage in human cells.

Furthermore, the study also found that chronic exposure is worse than acute exposure, with the chemical compounds in samples exposed to chronic thirdhand smoke existing in higher concentrations and causing more DNA damage than samples exposed to acute thirdhand smoke, suggesting that the residue becomes more harmful over time.

Berkeley Lab scientists (from left) Altaf Sarker, Mohamad Sleiman, Lara Gundel, Bo Hang and Hugo Destaillats worked on the thirdhand smoke study.

“This is the very first study to find that thirdhand smoke is mutagenic,” said Lara Gundel, a Berkeley Lab scientist and co-author of the study. “Tobacco-specific nitrosamines, some of the chemical compounds in thirdhand smoke, are among the most potent carcinogens there are. They stay on surfaces, and when those surfaces are clothing or carpets, the danger to children is especially serious.”

Their paper, “Thirdhand smoke causes DNA damage in human cells,” was published in the journal Mutagenesis. The lead investigator was Bo Hang, a biochemist in the Life Sciences Division of Berkeley Lab; he worked with an interdisciplinary group, including chemists from Berkeley Lab’s Environmental Energy Technologies Division — Gundel, Hugo Destaillats and Mohamad Sleiman — as well as scientists from UC San Francisco, UCLA Medical Center and the University of Texas.

It is the first major study of disease-related mechanisms to come out of the California Consortium on the Health Effects of Thirdhand Smoke, which was established two years ago largely as a result of work published in 2010 by Gundel, Destaillats, Sleiman and others. The consortium is funded by the Tobacco-Related Disease Research Program, which is managed by the University of California and funded by state cigarette taxes.

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New strategies aim to keep high-risk youth free of HIV infection

UC’s California HIV/AIDS Research Program funds three projects to help curb HIV.

Studies funded by UC’s California HIV/AIDS Research Program hope to curb HIV in the state by engaging people at high risk in innovative prevention efforts in their communities.

Last year, Grant Lindsey visited Oakland’s Downtown Youth Clinic for the first time, accompanying his partner who was being treated there for HIV. Lindsey is not HIV-positive, but this was a new relationship, and he was there to offer help and encouragement.

“I really wanted to support my partner, and I wanted to get educated for myself,” he said. “I wanted to get up to date as far as HIV and safe sex were concerned.”

While at the clinic, Lindsey was tested for HIV. He also talked with the clinic director and medical staff about his new relationship, and he got answers to questions that had been worrying him.

Soon, he was volunteering for a new study to test an HIV prevention pill (Truvada), which has been found to protect uninfected persons against the virus. This prevention pill is part of a new strategy called PrEP (pre-exposure prophylaxis) that includes taking the daily antiretroviral medication, Truvada, which was approved last year by the FDA. Truvada is provided for the study by its maker, Gilead Sciences, Inc.

This bold research, which is funded by UC’s California HIV/AIDS Research Program (CHRP), engages people at high risk for HIV infection in an innovative new biomedical prevention effort in their communities. The study in Oakland and other East Bay cities is one of three PrEP research projects funded by CHRP to help curb HIV in California. The combined effort is the largest PrEP demonstration project in the U.S. (See “Combining a prevention pill with community treatment programs“)

“I didn’t know anything about this,” said Lindsey. “It’s amazing. HIV is still rampant, and not enough people are talking about it.”

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Related link:
UCTV: HIV: Past present and future — Mini Medical School for the public presented by UCSF Osher Center for Integrative Medicine

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Health professions education growing in new directions, UC report finds

Enrollment has increased significantly in medicine, nursing, pharmacy and public health.

Click image to download report

>>Download report

The University of California has issued a report that highlights some of the recent trends associated with the rapid growth in health professional schools and enrollment.

Enrollment in U.S. health professional schools has increased significantly in medicine, nursing, pharmacy and public health, according to the report, “A New Era of Growth: A Closer Look at Recent Trends in Health Professions Education.” For example, there has been unprecedented growth in total U.S. pharmacy student enrollment through expansion of existing programs and the establishment of new schools. Since 2005 alone, the number of accredited pharmacy schools has risen 48 percent (87 to 129).

The total enrollment and number of new U.S. medical schools also has increased. More striking, however, has been the rapid growth in the number of for-profit international medical schools located in the Caribbean and seeking to attract U.S. students. Growth has been more moderate in dentistry, optometry and veterinary medicine.

The report describes some of the changes in health professions education since 2007, when UC issued “A Compelling Case for Growth,” an in-depth review of health workforce needs as part of a systemwide planning effort that helped pave the way for enrollment growth at all five of UC’s longstanding medical schools, establishment of a new nursing school at UC Davis, and the recent accreditation and establishment of UC’s sixth school of medicine at UC Riverside.

The new report reviews the seven fields in which UC has health professional schools. The report also identifies trends and provides information by profession about the number of schools and enrollment in California and nationally. Information regarding current tuition levels by institution also is included.

“As the nation’s largest health sciences instructional program, UC has an important role to play in informing the public about the state of health professions education,” said Dr. Cathryn Nation, UC associate vice president for health sciences. “The ‘New Era of Growth’ report provides a valuable snapshot of trends that deserve our attention and further discussion.”

Trends identified in the report include:

  • Rapid growth in educational programs and total enrollment. Since 2007, the number of U.S. schools in the seven health professions surveyed has grown by 48 percent (865 to 1,283). As a result, enrollment has increased by 34 percent (252,484 to 339,107), with the majority of this growth taking place primarily in medicine, nursing, pharmacy and public health.
  • Development of new programs and business models. For-profit schools and programs have proliferated, both in the U.S. and the Caribbean, where 22 of the 61 medical schools admitted their first classes in the past decade. Non-research institutions have added new schools of pharmacy and dentistry. Accelerated and alternate-entry programs have grown, particularly in nursing. Professional doctorates have increased, as have programs that deliver education online, with growth in online public health programs.
  • Rising student costs and indebtedness. Between 2005 and 2010, UC medical schools experienced a nearly 50 percent increase, on average, in the four-year cost of attendance. Not surprisingly, student debt also is rising. Viewed over a longer period, the increase is even more dramatic. The total cost of attendance has increased for all UC professional degree programs, posing new challenges for students interested in pursuing careers in public service. For example, the average educational debt of veterinary medicine graduates (excluding undergraduate loans) at UC Davis nearly quadrupled from $29,770 in 1993 to $118,772 in 2011.

Recent growth at UC

Across the UC system, relatively modest, planned enrollment growth in medical student enrollment has occurred over the past decade. This has occurred through new UC Programs in Medical Education (PRIME) that focus on the needs of medically underserved communities. Through this special initiative, UC boosted total medical student enrollment by approximately 350 students across the UC system. However, most of this growth, and most that is occurring in nursing, has been unfunded by the state. Major multiyear budget cuts and a lack of state funding also contributed to a delay in the opening of UC Riverside’s new school of medicine, which will welcome its first class of 50 students in fall 2013.

Looking toward the future

Notwithstanding the growth in enrollment and establishment of new schools across the U.S., workforce shortages persist in many health professions, including medicine, public health and others — needs that will increase dramatically as provisions of health care reform take effect. The balance is currently shifting for some professions. In pharmacy, for instance, the profession has experienced such rapid growth in recent years that some estimates suggest a total national supply of pharmacists that may outpace future demand. Amid these many changes, it will be important to monitor the impact that the new schools and programs make, with particular attention to issues of quality, cost and student success, according to the report.

“As the higher education community plans for the future, the importance of maintaining educational quality, improving access and affordability for students, and improving access and health outcomes for patients are among the central goals that must remain in focus,” the report states.

About UC Health
University of California Health includes five academic health centers with 10 hospitals and 18 health professional schools and programs on seven UC campuses — UC Berkeley, UC Davis, UC Irvine, UCLA, UC Riverside, UC San Diego and UC San Francisco. For more information, visit http://health.universityofcalifornia.edu.

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Innovation center colloquium tackles ‘triple aim’ of improving health care

Talks airing on UCTV.

>>UC awards 11 grants to improve care to surgery patients
>>View colloquium talks on UCTV
>>View speaker presentations
>>View poster presentations
>>View agenda

By Alec Rosenberg

The University of California is taking steps to be at the forefront of health care reform in providing higher quality care that is more efficient, affordable and effective for Californians.

The challenge is to accelerate these efforts to meet the demands of a changing health care market, speakers said at the UC Center for Health Quality and Innovation’s second annual colloquium, May 3 at the Oakland Marriott City Center.

About 275 people attended the colloquium, and the talks can be viewed on UCTV beginning today (May 14). (View UCTV schedule.) Speakers included innovation center leaders and grant recipients as well as health insurance executives and the head of a business coalition focused on health care. (View agenda, speaker presentations.)

“The hospital of old is not the health system of the future,” said innovation center Executive Director Terry Leach. “The new paradigm with health care reform is population management” and thinking about innovative delivery methods such as team-based care, telemedicine and group visits, where such approaches improve the quality of care.

UC Health launched the innovation center in October 2010 with funding from its medical centers at UC Davis, UC Irvine, UCLA, UC San Diego and UC San Francisco. The center’s goal is to help achieve the “triple aim” of better health care and better population health while better controlling costs of care.

The center “has been very successful in terms of sending a message that we think work in these areas is very important to the University of California,” said its chairman, Dr. John Stobo, UC senior vice president for health sciences and services. UC Health needs to build on the center’s initial successes, continue to leverage UC’s strengths in research and education, and work more rapidly to roll out clinical improvements systemwide, Stobo said.

Keynote speaker Mark Laret, an innovation center board member and UCSF Medical Center CEO, encouraged the audience to think differently about health care as leaders in other industries have done, such as Apple’s Steve Jobs.

“Our lives have been vastly improved by people who dared to think differently,” Laret said. “Society is giving us a new challenge. … We have to figure out how are we going to become more nimble.”

In a panel discussion, health insurance executives pointed to collaborations with UC and other organizations that have improved care and effectively controlled costs.

“We have an affordability crisis. We can solve it. What we need is cooperation,” said Paul Markovich, Blue Shield of California president and CEO. An example, he said, is the accountable care organization that Blue Shield formed in San Francisco with UCSF, Dignity Health and Hill Physicians, which has saved $10 million.

Anthem Blue Cross has partnered with hospitals, including UC medical centers, on agreements that tie rates to a hospital quality program focused on performance in patient safety, patient health outcomes and member satisfaction. In November, Anthem and UC Health formed an alliance that will focus on care innovation and California health policy development with the purpose of improving access to affordable, quality health care for California residents.

“We’re actively talking to providers,” said Aldo De La Torre, Anthem Blue Cross vice president of provider contracting. “Together we can bring a solution to the problems Paul (Markovich) has laid out.”

Meanwhile, Health Net formed a tailored network for UC employees that includes UC medical centers among the providers, which has saved $72 million in two years, said Steven Sell, president of Health Net’s Western Region Health Plan and of Health Net of California. Health plans are looking for continued efforts to reduce the cost of care, increase the quality of care and improve population health, Sell said.

Employers want increased value in health care, with better quality and more affordability, said David Lansky, president and CEO of the Pacific Business Group on Health, whose members include Safeway, Target, Walmart and UC.

Innovation center grant recipients from UC’s five medical center campuses gave examples of their efforts to increase value through projects such as expanding telehealth, avoiding unnecessary medical tests and enhancing care after surgery.

Dr. Ralph Green of UC Davis, who attended the colloquium, said the event highlighted the important role that UC can play as a system.

“There is so much talent distributed among all of the campuses that collectively I think UC could provide leadership not only to others in academic medicine but nationally in terms of how to make health care better,” Green said.

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UC medical centers will expand palliative care with $1M grant

Systemwide project seeks to improve quality of care for ICU patients and families.

Wendy Anderson, UC San Francisco

The University of California is leveraging its expertise to enhance patient care at UC medical centers systemwide, awarding a $1 million grant to expand specialized care for seriously ill patients.

The two-year project, led by Wendy Anderson, M.D., M.S., of UC San Francisco, seeks to improve the quality of care for patients in the intensive care unit (ICU) and their families. The project will expand a training program for bedside nurses to increase the integration of palliative care into ICUs across UC Health.

Palliative care is specialized medical care for seriously ill patients and their families that focuses on quality of life: managing pain, symptoms and stress of serious illness, and helping to ensure that patients get the type of care they want. Palliative care improves care for patients and their families, and also decreases costs. While the field has been growing rapidly – two-thirds of U.S. hospitals with more than 50 beds now have a palliative care team – access is still limited. Even in hospitals that have palliative care, many seriously ill patients do not receive it.

The grant is being awarded by a new joint venture between the UC Center for Health Quality and Innovation and UC’s systemwide Office of Risk Services. The joint venture, called the Center for Health Quality and Innovation Quality Enterprise Risk Management, is part of an effort to improve patient care and satisfaction throughout UC Health.

“We are focused on transforming health care so that it improves the quality of the care we give, the efficiency of the care we give and improves population health,” said Terry Leach, executive director of the UC Center for Health Quality and Innovation. “I can’t think of a better example than to improve care to the seriously ill.”

The project, led by Anderson and her co-investigators, Steven Pantilat, M.D., from the UCSF School of Medicine and Kathleen Puntillo, R.N., Ph.D., from the UCSF School of Nursing, aims to increase the integration of palliative care in the ICUs of the medical centers at UC Davis, UC Irvine, UCLA, UC San Diego and UCSF.

ICU stays can be incredibly difficult for patients and families alike. Patients frequently experience pain and other symptoms, and may receive treatments that are not consistent with their wishes. Families often suffer from emotional distress both during and after patients’ ICU stays. When integrated into ICUs, palliative care can improve management of patients’ symptoms, decrease family members’ distress, help ensure that the care provided matches patient preferences and increase satisfaction. It also can support ICU providers and decrease ICU length of stay and costs.

Anderson, a UCSF assistant professor of medicine, received a UC innovation center fellowship last year during which she and the UCSF team trained 68 UCSF bedside nurses to provide palliative care in the ICU. This new grant will help establish a collaborative of ICU and palliative care nurse and physician leaders from throughout UC Health. It will expand a nurse training program for ICU bedside nurses and identify and implement best practices in ICU-palliative care integration across UC medical centers.

“The UC medical centers have world-class palliative care services,” Anderson said. “But palliative care isn’t routinely involved in the care of patients in the ICU. We want to make sure that every patient and family member in the ICU at all the UC medical centers has access to palliative care.”

The team plans to provide palliative care training to 600 bedside nurses at UC medical centers over two years and put in place systems to sustain and continue to expand the integration of palliative care into the care of seriously ill patients.

Campus leaders working with Anderson on the palliative care project include:

UC Davis
Eric Moore, R.N., M.B.A.; Janice Noort, R.N., N.P., M.S., A.C.H.P.N.; Diana Pearson, R.N., M.S.N., C.C.R.N.

UC Irvine
Deborah Boyle, R.N., M.S., A.O.C.N.S.; Michelle Grywalski, R.N., B.S.N.; Solomon Liao, M.D.

UCLA
Bruce Ferrell, M.D.; Jeannette Meyer, R.N., M.S.N., A.C.H.P.N.; Edith O’Neil-Page, R.N., M.S.N., A.O.C.N.S.

UC San Diego
Julia Cain, R.N., M.S.N., A.N.P.; Heather Herman, R.N., M.S., A.N.P.; William Mitchell, M.D.

UCSF
Susan Barbour, R.N., M.S., W.O.C.N., A.C.H.P.N.; Jenica Cimino, B.A.; Denah Joseph, M.F.T.; Michelle Milic, M.D.; Steven Pantilat, M.D.; Kathleen Puntillo, R.N., Ph.D.; Kathleen Turner, R.N., C.H.P.N., C.C.R.N.-C.M.C.

Media contacts:
University of California Office of the President
(510) 987-9200

Karin Rush-Monroe
UC San Francisco
(415) 502-NEWS

About UC Health
University of California Health includes five academic health centers — UC Davis, UC Irvine, UCLA, UC San Diego and UC San Francisco — with 10 hospitals and 18 health professional schools and programs on seven UC campuses. For more information, visit http://health.universityofcalifornia.edu.

About the UC Center for Health Quality and Innovation
UC Health launched the Center for Health Quality and Innovation in October 2010. The center is designed to promote, support and nurture innovations at UC medical center campuses and hospitals to improve quality, access and value in the delivery of health care. For more information, visit http://health.universityofcalifornia.edu/innovation-center.

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Global forum provides food for thought

UC convenes discussion on how to sustainably feed 8 billion people by 2025.

Michael Specter moderates a panel discussion on feeding a world of 8 billion people. (Click image for larger view.)

By Alec Rosenberg

The University of California, through its Division of Agriculture and Natural Resources, hosted a wide-ranging, provocative discussion Tuesday (April 9) on how to sustainably feed 8 billion people by 2025.

Several themes emerged from the UC Global Food Systems Forum: Take a bottom-up approach. Focus on solutions. Pursue low-hanging fruit. Decrease food waste. Be practical. Be innovative. Involve education. But opinions differed on how to balance small- and large-scale farming, the role of genetically modified organisms, and what should be the most important area of focus.

More than 475 people attended the food forum in Ontario, Calif., which also reached a worldwide virtual audience. A live webcast received 1,500 unique viewers from 34 countries, while a steady stream of tweets at #Food2025 made the conversation a trending topic on Twitter. With more than 1 billion people going hungry every day and 1 billion people overweight, the conversation was timely.

“We must act now to improve the food and nutrition supply of people in poor countries and communities throughout the world,” said keynote speaker Mary Robinson, former president of Ireland and president of the Mary Robinson Foundation – Climate Justice.

Mary Robinson and Barbara Allen-Diaz at the UC Global Food Systems Forum. (Click image for larger view.)

Myriad challenges

The daylong forum, part of ANR’s statewide conference, addressed the challenges faced by food producers, suppliers and consumers in a world of growing population, strains on natural systems, climate change, shifting geopolitics and other converging forces. The event convened some of the world’s leading experts — farmers, researchers, policymakers, economists, environmentalists and others — with the New Yorker’s Michael Specter moderating a global panel and author and journalist Mark Arax moderating a California panel. The speakers offered thoughtful insights and solutions.

“This is fundamental to our mission as a land-grant university,” said UC ANR Vice President Barbara Allen-Diaz. “Our goal is to take these brilliant ideas and turn them into brilliant plans of action.”

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