1. THE PARALLEL PROCESS OF EDUCATIONAL AND PRACTICE TRANSFORMATION
JIMMY H. HARA, MD, FAAFP
FAMILY MEDICINE RESIDENCY DIRECTOR EMERITUS
KAISER PERMANENTE LOS ANGELES
PROFESSOR OF CLINICAL FAMILY MEDICINE
DAVID GEFFEN SCHOOL OF MEDICINE AT UCLA
AT-LARGE DIRECTOR, BOARD OF DIRECTORS
AMERICAN BOARD OF FAMILY MEDICINE

2. THE LEGACY OF KAISER PERMANENTE, THEN…

3. THE LEGACY OF KAISER PERMANENTE, NOW…

4. LEADING THE TRANSFORMATION…
Benjamin Chu, MD
President, KFH/HP
Former Assoc Dean
NYU/Cornell
Former Director
NY Public Hospitals
Member of Bell Commission

5. EXTENDING CARE TO THE COMMUNITY…
HEAL INITIATIVE
ALL/PHASE INITIATIVE
TRAINING COMMUNITY HEALTH PROMOTERS (PROMOTORAS)
SPECIALTY CARE INITIATIVE
OPERATION SPLASH

6. THE FOURTH AIM… IMPROVE THE HEALTH OF THE POPULATION
REDUCE, OR AT LEAST CONTROL, THE PER CAPITA COST OF CARE (BY AVOIDING UNNECESSARY TESTS AND TREATMENT)
ENHANCE THE PATIENT EXPERIENCE OF CARE (INCLUDING ACCESS, QUALITY, AND RELIABILITY)
THE FOURTH AIM OF ED WAGNER, MD, MPH, MACP: “RE-ESTABLISH PRIMARY CARE AS THE FOUNDATION OF U.S. HEALTH CARE DELIVERY IN THE CONTEXT OF THE PATIENT CENTERED MEDICAL HOME”

7. BECOMING A PCMH REQUIRES TRANSFORMATION…
CHANGE IS HARD; TRANSFORMATION TO A PCMH REQUIRES EPIC WHOLE-PRACTICE REIMAGINATION AND REDESIGN, WITH A “CORE STRUCTURE”
SOUND FINANCIAL SYSTEMS
STABLE STAFF AND LEADERSHIP
STABLE INFORMATION TECHNOLOGY
KEY FACTORS FOR SUCCESS = “ADAPTIVE RESERVE”
STRONG RELATIONSHIPS WITHIN PRACTICE
FACILITATIVE LEADERSHIP
PROTECTED GROUP REFLECTION TIME
ATTENTION TO LOCAL ENVIRONMENT
A LEARNING ENVIRONMENT

8. HEALTH EQUITY AND CULTURALLY RESPONSIVE CARE
KP FUNDED UCLA CEHD
UCLA KP CENTER FOR HEALTH EQUITY
RECOGNIZES NEED FOR CULTURALLY SENSITIVE AND RESPONSIVE CARE TO OPTIMIZE QUALITY OF CARE AND CARE EXPERIENCE
HEALTH EQUITY AND SOCIAL JUSTICE INCLUDES ATTENTION TO GENDER, ETHNICITY, LANGUAGE, AGE, INCOME LEVEL, HEALTH LITERACY, ETC…

9. CULTURALLY RESPONSIVE CARE

10. CULTURALLY RESPONSIVE CARE

11. LANGUAGE LINE

12. COMMITTED TO HEALTH EQUITY IN GME
SIX FAMILY MEDICINE RESIDENCY PROGRAMS IN SOUTHERN CALIFORNIA, TWO IN NORTHERN CALIFORNIA
FULLY INTEGRATED ELECTRONIC HEALTH RECORD
FELLOWSHIPS IN SPORTS MEDICINE, GERIATRIC MEDICINE, AND PALLIATIVE CARE
COMMITMENT TO COMMUNITY (COMMUNITY HEALTH CENTERS AND HEALTH FAIRS)

13. ROLE OF PALLIATIVE CARE
PALLIATIVE CARE TEAM: SPIRITUAL CONSULTANT, PHYSICAL AND OCCUPATIONAL THERAPISTS, NURSE, SPECIALTY CONSULTANTS, PRIMARY CARE PHYSICIANS, FAMILY MEMBERS, FRIENDS, AND PATIENT
DETERMINE GOALS OF CARE
REDUCE UNNECESSARY DIAGNOSTIC AND THERAPEUTIC MISADVENTURES

14. PALLIATIVE CARE AND GERIATRIC MEDICINE
TWO FELLOWSHIPS WORK HAND IN GLOVE
FAMILY MEDICINE RESIDENTS WORK WITH FELLOWS AND FACULTY MONTHLY IN LOCAL SKILLED NURSING FACILITY
MAKE HOME HOSPICE VISITS
ALL ADVANTAGES OF INTEGRATED SYSTEM AMBULATORY CARE AND HOSPITAL CARE ARE CONTINUED INTO THE COMMUNITY

15. OTHER NECESSARY EDUCATIONAL TRANSFORMATIONS
MILESTONES PROJECT
RESIDENCY COMPETENCY METRICS
INTER-PROFESSIONAL COALITION
IMPLICATIONS FOR WORKFORCE
LCME CURRICULAR MANDATES

16. Kaiser Permanente.thrive.
More to come…
Kaiser Permanente.thrive.