UC San Diego Health Celebrates Inaugural Improvement Excellence Awards

“UC San Diego Health’s unprecedented growth has pushed us to become better, more consistent and more agile,” said Ashley Gambhir, executive director of transformation at UC San Diego Health. “Efforts like these projects demonstrate how UC San Diego Health relentlessly strives to be an incredible place to work and receive care.”

To qualify for an award, the project submissions must align with at least one of UC San Diego Health’s strategic goal categories of excellence, which include:

• Pursuit of Quality 
• Patient Experience
• Improving Access
• Advancing Health Equity
• Fostering a Culture of Belonging
• Efficiency of Operations

Judging for the submissions was conducted by a panel of 10 UC San Diego Health employees who represented a range of departments at UC San Diego Health, including health justice and equity and population health. Criteria considered when reviewing submissions included: benefit to the organization and patients, sustainment, scalability (either internal or external) and creativity. 

“We attract, recruit and retain the absolute best staff at UC San Diego Health,” said Margarita Baggett, RN, MSN, chief clinical officer at UC San Diego Health. “The remarkable efforts highlighted in these award nominations bring purpose, meaning and joy to our work and ensure patients are receiving the highest level of care. It’s an honor of ours to recognize the team members involved in the work at this year’s Improvement Excellence Awards.”

2023 Improvement Excellence Award Winners

• Improvement of the Year – Pursuit of Quality: Advanced Certification in Spine Surgery
  In November 2022, a multidisciplinary team at UC San Diego Health earned The Joint Commission’s Gold Seal of Approval for Advanced Certification in Spine Surgery, which is granted to organizations with data-driven care processes, patient safeguards and demonstrated high quality patient outcomes with low complication profiles. 
  
  The team’s main focus in this project was to develop a “Spine Passport” that facilitated better care for spinal surgery patients and developed standard work processes for clinical staff involved in such surgeries. The process involves pre-surgery education with the patient to ensure pertinent information is readily available for the clinical team.
   
• Improvement of the Year – Patient Experience: Medical Offices South Pharmacy at UC San Diego Medical Center in Hillcrest
  The Medical Offices South pharmacy at UC San Diego Medical Center in Hillcrest utilized surveys to receive direct patient feedback in an effort to improve patient satisfaction at the pharmacy. The goal of this project was to ensure survey responses were easily accessible to the pharmacy team so the patient’s voice was heard and responses could be used to improve processes. With this change, the team has experienced an increase in their Net Promoter Score, a common metric used in customer experience surveys, from 71.2 in April 2022 to 91.9 in November 2022.
   
• Improvement of the Year – Improving Access: UCSD at Home
  The UCSD at Home – Emergency Department to Home Program ensures that patients leaving the emergency departments at UC San Diego Health receive care that is coordinated by utilizing an interdisciplinary care team approach. 
  
  As part of the program, case management teams collaborate in real time with population health, home health and physicians to identify eligible patients for discharge and follow-up care that is conducted at their home.
  
  UCSD at Home – Emergency Department to Home Program also received the Crowd Vote award and was the 2023 Overall Grand Prize Winner.
   
• Improvement of the Year – Advancing Health Equity: Championing Sickle Cell Disease in the Emergency Department
  This project aimed to improve health equity for patients with sickle cell disease, which predominately affects African Americans, by addressing specific issues patients frequently experience, including: lack of understanding of sickle cell disease, stigma and discrimination, inadequate pain management and lack of continuity of care. 

• Improvement of the Year – Fostering a Culture of Belonging
  UC San Diego Health leaders collected feedback, identified best practices and created a collection of resources that managers can utilize to ensure team members feel that the organizational culture is one that is welcoming and where all employees feel valued, seen, heard and treated with respect.
   
• Improvement of the Year – Efficiency of Operations: Eliminating Discharge Barriers
  The Trauma Progressive Care Unit at UC San Diego Health's Level 1 Trauma Center in Hillcrest plays a critical role in maintaining continuous patient flow, as most patients are admitted directly from trauma and the surgical intensive care unit. To achieve organizational discharge delay goals, the unit deployed a standardized discharge process amongst the interdisciplinary team utilizing improved workflows and a discharge board for transparent communication. Since project implementation, the unit's average discharge delay/month has steadily decreased, outperforming the organizational goal. Overall, the project has shown great promise in improved patient outcomes and decreased wait times for inpatient hospital beds.
   
• Local Transformation – Pursuit of Quality for Patients Post-Surgery
  Early mobilization is an integral part of the Enhanced Recovery After Surgery Program at UC San Diego Health, ensuring that surgical patients are mobile as early as possible post-surgery to improve their health outcomes. Specifically, within 12 to 16 hours of being admitted to the nursing unit after surgery, it’s recommended that patients are participating in a minimum level of activity, such as marching in place or walking, as it helps patients recover after surgery.
  
  To follow early mobilization compliance rates, a team in the surgical oncology unit at Jacobs Medical Center created the program “Stepping on UP,” which offered education to staff on the importance of early mobilization and utilized a tracking board centrally located in the nursing station of the unit. The tracking board listed which patients met early mobilization requirements, which was updated by the nursing team as the mobilization was completed. 
   
• Local Transformation – Patient Experience: Inpatient Quiet-At-Night Program
  Inpatient surgical services nursing units at UC San Diego Medical Center in Hillcrest partnered with the Office of Experience Transformation in discovering new ways for patients to receive the sleep they need while in our care. Studies have shown that a serene hospital setting promotes less stress, improves rest and sleep, healing, functional and psychological wellbeing, less incidence of delirium, decreased use of sleep-promotion pharmaceuticals, and better medical outcomes for patients. Additional benefits include reduced length of stay, decreased hospital costs and improved patient experience.
  
  The program included adoption of an 11 p.m. to 5 a.m. “Quiet Hour,” which consisted of dimming hallway lights, mitigating environmental noises, and upgrading call lights in shared patient rooms to allow patients to watch TV quietly while using headsets. 
  
  The nursing team also offered patients a sleep menu to ensure each patient’s personal night time preferences are accommodated, such as closing blinds, dimming the computer monitor, or providing extra bedding. The menu also includes the option to receive a Quiet Kit, which contains a sleep mask, earplugs, and a calming aromatherapy patch.

• Local Transformation – Improving Access: New Patient Access in the Adult Cystic Fibrosis Program
  The Adult Cystic Fibrosis Program increased appointment availability by implementing a new patient scheduling intake process that provided new patients with a telehealth visit. Since offering telehealth appointments to new patients, the percentage of new patients scheduled within seven days increased from 20% to 45%. 
   
• Local Transformation – Fostering a Culture of Belonging: Nurse Training and Incentive Program Improvements
  The Precepting with Pride Program — a training program for experienced nurses who teach clinical skills to new nurses — implemented a structured, evidence-based curriculum that increased the number of standards taught, enhanced teaching strategies and doubled the number of teaching hours and professional development hours provided.
  
  This team also worked with many stakeholders to not only negotiate an increase in hourly preceptor incentive but streamline the process for nurses to request and receive the incentive. As a result of this program, nurse participation rates and satisfaction increased supporting the organization’s efforts to decrease reliance on contract labor and decrease nurse vacancy rates.
   
• Local Transformation – Efficiency of Operations: Collaboration of Multi-Disciplinary Teams for Quality Improvement
  Through implementing a weekly, one-hour meeting called “Power Hour,” a multidisciplinary group of team members, including nurses, nursing leadership, advanced practice providers and physician leadership collaborated to identify and address themes and trends to improve quality and safety. The meeting helped identify and immediately address any timely issues, such as patient discharges, rapid response times, rounding needs and more, which helped sustain a high quality of care provided to patients.

“Our amazing team at UC San Diego Health has become masterful at quickly adapting to our dynamic, complex and responsive industry, and these awards recognize and reflect that incredible work,” added Gambhir. “As a result, we’re seeing enhanced processes that ensure patient safety, improve patient experience and increase operational efficiency and sustainability.”