BEST OF HEALTH PILOTS: Missed Appointments, Missed Prevention Opportunities

Embrace change and maintain openness in the journey towards trauma-informed care. 

-It's through this wisdom and guidance that we're excited to bring you a revealing and heartfelt interview featuring the Highland Hospital pediatrics team. Delving into understanding adverse childhood experiences (ACEs) and trauma's impact on health, you'll hear each care team member offer insights on implementing ACEs screening and supportive measures, reflecting on hurdles overcome and collective milestones achieved.

As one of the exemplary teams that are part of the Resilient Beginnings Network (RBN), Highland Hospital Pediatrics invited Health Pilots to host this conversation with them in-person at their facility in Oakland, California – gathered around the table to openly share and unpack their journey through this program with their coach and medical director of RBN, Dr. Dayna Long. Take in the valuable lessons they learned individually and as a care team - and the unique, transformative impact of the Resilient Beginnings model on patient care.

Learn more about the people, places, and ideas in this episode: 

• "What are adverse childhood experiences (ACEs)?"
• Pediatric ACEs and Related Life Events Screener (PEARLS)
  • Example of PEARLS tool (for screening children)
• Visit Highland Hospital, Alameda Health System - Alameda Health System’s flagship, with 236 inpatient beds; a renowned regional trauma center; nationally recognized medical and clinical teaching and research; and state-of-the-art primary, specialty, and multi-specialty care. Its new Acute Care Tower is host to topflight maternal child services and other advanced care.
• Embracing Staff Training To Help Patients With Trauma - related article featuring the pediatric care team at Highland Hospital within Alameda Health System (March 2023)
• More on Resilient Beginnings Network (RBN), a Center for Care Innovations learning program dedicated to advancing pediatric care delivery models that are trauma- and resilience-informed so that 100,000 young children and their caregivers have the support they need to be well and thrive.
• HOPE Framework, or Healthy Outcomes from Positive Experiences can ease toxic stress and help children and youth grow into more resilient, healthier adults. HOPE identifies ways that our communities and systems of care can better ensure that all children have more positive experiences and that all families have support to nurture and celebrate their strengths. The Four Building Blocks of HOPE are composed of key positive childhood experiences (PCEs). The sources of those experiences and opportunities are the foundation for healthy childhood development.

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© 2023 Center for Care Innovations. All Rights Reserved.

Explore the profound shift from viewing trauma-informed care as a logistical process to embracing it as a transformative philosophy. Join the dedicated pediatric care team from Petaluma Health Center's West Marin Clinics as they share insights from their Resilient Beginnings journey.

This episode delves into understanding trauma's community-level impact on marginalized groups. The care team emphasizes authentic patient interactions, acknowledging the inherent resilience in individuals, families, and communities. They advocate for redesigning care environments to confront racial disparities within teams and communities, recognizing historical injustices. The team navigates the need to address racial inequities despite the complexities existing within organizational structures, essential for both internal healing and addressing external disparities.

Tune in as the Petaluma Health Center's West Marin Clinic pediatric care team advocates for collective responsibility to sustain racial equity, resilience, and healing in healthcare - envisioning a future that champions inclusivity and a commitment to redefine patient care beyond clinic walls. 

Learn more about the people, places, and ideas in this episode: 

• "What are adverse childhood experiences (ACEs)?"
• Visit Petaluma Health Center (PHC) - committed to providing high quality health care with access for all in Southern Sonoma County in Northern California, PHC has built a strong reputation for it’s innovation and has been on the leading edge of providing comprehensive primary health care in a team based, patient centered system, emphasizing overall wellness and the value of the patient provider relationship.
• Rural West Marin Clinic Works with Family Advocates to Connect Patients to Services - related article featuring PHC's West Marin Clinic (March 2023)
• More on Resilient Beginnings Network (RBN), a Center for Care Innovations learning program dedicated to advancing pediatric care delivery models that are trauma- and resilience-informed so that 100,000 young children and their caregivers have the support they need to be well and thrive.
• La Lotería Mexicana: A Brief History of a Famous Game

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🎙Podcast production services by Wayfare Recording Company

© 2023 Center for Care Innovations. All Rights Reserved.

Understanding trauma and resilience in children and families begins with supporting the care team and staff. In this episode, primary care pediatrician Niyi Omotoso and licensed clinical social worker Gillian Fynn from LifeLong Medical Care within the Resilient Beginnings Network unveil the profound impact of trauma-informed care in pediatric medicine.

Discover LifeLong Medical Care's journey through this transformative cultural shift and its influence on staff, providers, and leadership.  Learn about their efforts to establish foundational trauma-informed approaches, laying the groundwork for enhancing care delivery by centering collective resilience, staff/provider wellness, and fostering meaningful engagement with families.

Learn more about the people, places, and ideas in this episode: 

• "What are adverse childhood experiences (ACEs)?"
• Pediatric ACEs and Related Life Events Screener (PEARLS)
  • Example of PEARLS tool (for screening children)
• "What are social determinants of health (SDOH)?"
• Visit LifeLong Medical Care - serving the Bay Area for more than 45 years, LifeLong Medical Care provides high-quality health, dental, and social services to underserved people of all ages; creates models of care for the elderly, people with disabilities and families; and advocates for continuous improvements in the health of our communities.
• How a Health Center That Screens for Childhood Trauma Worked to Heal Itself First - related article featuring LifeLong Medical Care (May 2023)
• More on Resilient Beginnings Network (RBN), a Center for Care Innovations learning program dedicated to advancing pediatric care delivery models that are trauma- and resilience-informed so that 100,000 young children and their caregivers have the support they need to be well and thrive.
• Renée Boynton-Jarrett, MD, ScD - Founding Director of Vital Village 
  • Featured in Breaking the Cycles of Trauma through Recognition and Healing,  - CCI webinar presented by the Resilient Beginnings Network
• CenteringParenting is a fam­i­ly cen­tered way to get care for moms, babies, and families. CenteringParenting is a breakthrough strategy for advancing early relational health and transforming the child health delivery system to be ever more family-centric, equitable and resiliency focused.
• Dr. Nadine Burke Harris, TEDMED Talk - How childhood trauma affects health across a lifetime

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🎙Podcast production services by Wayfare Recording Company

© 2023 Center for Care Innovations. All Rights Reserved.

Health Pilots presents our next Resilient Beginnings feature, shining a light on the care team at Children's Health Center (CHC) at Zuckerberg San Francisco General Hospital. CHC's Kathryn Hallinan Aguilar, Maite Garcia, and Dannielle McBride take us inside the clinic's distinctive environment where a varying range of patient experiences, needs, and challenges converge. They discuss with us the intricate coordination required in operating within a complex hospital system. Tune in to discover how their collective expertise and collaborative drive work toward bringing forth inclusive, holistic care for all - striving for comprehensive and equitable access to healthcare.

Learn more about the people, places, and ideas in this episode: 

• "What are adverse childhood experiences (ACEs)?"
• Visit the Children's Health Center - Zuckerberg San Francisco General Hospital - the Children’s Health Center provides comprehensive, high-quality pediatric care for children from birth up to age 21. Health services include primary care for newborn and infants, children, and teenagers 6 days per week including evenings and Saturdays.
• More on Resilient Beginnings Network (RBN), a Center for Care Innovations learning program dedicated to advancing pediatric care delivery models that are trauma- and resilience-informed so that 100,000 young children and their caregivers have the support they need to be well and thrive.
• Cultural Humility Versus Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education - M. Tervalon and J. Murray-Garcia, 1998
• Listen to Kathryn Hallinan Aguilar featured on a recent episode of A Flourishing Start podcast: Nurturing Young Minds: Insights Into Infant and Early Childhood Mental Health (YouTube)

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🎙Podcast production services by Wayfare Recording Company

© 2023 Center for Care Innovations. All Rights Reserved.

Health Pilots continues with our next feature from the Resilient Beginnings Network! We welcome pediatrician Dr. Sheshashree "Shesh" Seshadri and pediatric care coordinator Melissa Pereda from Bay Area Community Health (BACH), discussing their comprehensive approach to pediatric care,  specifically in administering screenings to identify adverse childhood experiences (ACEs). Beyond sharing insights into workflows and processes, they discuss navigating the complexities that arise post-identification of ACEs and underscore the significance of establishing trust and rapport between providers and families.

Tune in to hear about BACH's collaborative efforts to compile a network of community-based organizations and their innovative use of technology to swiftly connect families with essential social and economic resources, ranging from housing needs to early intervention programs.

Learn more about the people, places, and ideas in this episode: 

• "What are adverse childhood experiences (ACEs)?"
• Pediatric ACEs and Related Life Events Screener (PEARLS)
  • Example of PEARLS tool (for screening children)
• "What are social determinants of health (SDOH)?"
• Visit Bay Area Community Health (BACH), formed during the middle of the COVID-19 pandemic, BACH brings more than 70 years of combined service to the area that stretched from Union City to Gilroy, across Alameda and Santa Clara Counties. BACH serves more than 100,000 people who rely on high-quality healthcare services, regardless of their immigration status, ethnicity, disabilities, or ability to pay.
• More on Resilient Beginnings Network (RBN), a Center for Care Innovations learning program dedicated to advancing pediatric care delivery models that are trauma- and resilience-informed so that 100,000 young children and their caregivers have the support they need to be well and thrive.
• Pediatric Care Coordinators: Closing the Loop to Help Children at Risk Thrive - article featuring BACH (April 2023)
• ACEs Aware, is a first-in-the nation effort and initiative to screen patients for adverse childhood experiences (ACEs) to help improve and save lives. ACEs Aware is bringing communities together in ways never before imagined to prevent, screen for, treat, and heal trauma-induced toxic stress. Together, we are getting to the root cause of some of the most harmful, persistent, and expensive health challenges facing our state and nation.
• HOPE Framework, or Healthy Outcomes from Positive Experiences can ease toxic stress and help children and youth grow into more resilient, healthier adults. HOPE identifies ways that our communities and systems of care can better ensure that all children have more positive experiences and that all families have support to nurture and celebrate their strengths. The Four Building Blocks of HOPE are composed of key positive childhood experiences (PCEs). The sources of those experiences and opportunities are the foundation for healthy childhood development.

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🎙Podcast production services by Wayfare Recording Company.

© 2023 Center for Care Innovations. All Rights Reserved.

Discover how Community Medical Centers (CMC) in California's Central Valley transformed healthcare over the past decade with trauma-informed practices. Partnering with Resilient Beginnings Network at the Center for Care Innovations, they deepened their commitment, hiring community health worker Victoria Franco and social worker case manager Maria Moreno. Together, they administer ACEs screenings, conduct follow-ups, and support care teams, empowering providers to prioritize quality medical care. Join Victoria, Maria, and CMC's Chief Behavioral Health Officer, Alfonso Apu, as they discuss providing guidance in trauma-informed care and the evolving focus on cultural sensitivity and patient-centered approaches.

Learn more about the people, places, and ideas in this episode: 

• "What are adverse childhood experiences (ACEs)?"
• Pediatric ACEs and Related Life Events Screener (PEARLS)
  • Example of PEARLS tool (for screening children)
• Visit Community Medical Centers (CMC), a growing non-profit network of neighborhood health centers serving San Joaquin and Solano counties in Northern California. CMC provides primary medical, dental, and behavioral health care along with supportive services to individuals and families in need.
• More on Resilient Beginnings Network (RBN), a Center for Care Innovations learning program dedicated to advancing pediatric care delivery models that are trauma- and resilience-informed so that 100,000 young children and their caregivers have the support they need to be well and thrive.
• How One California Clinic Tapped a Bilingual Medical Assistant to Lead ACEs Work - article featuring CMC (May 2023)
   

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🎙Podcast production services by Wayfare Recording Company.

© 2023 Center for Care Innovations. All Rights Reserved.

In this episode, we explore the world of Alternative Payment Models (APMs) in healthcare. APMs offer a revolutionary approach to incentivizing high-quality, cost-efficient care delivery. CCI's own, Jessica Ortiz, is joined by Amit Pabla of Valley Community Healthcare in Los Angeles, in this engaging conversation around the changing landscape of healthcare payments. From his unique operational perspective, Amit offers practical insights for healthcare organizations considering a transition to this model, and discusses the diverse applications of APMs as it pertains to social drivers of health. He also unveils essential elements of this cultural shift in healthcare and the journey towards a value-driven and quality-centric approach. 

Learn more about the people, places, and ideas in this episode: 

• Amit Pabla, Chief Operating Officer at Valley Community Healthcare
• Cal AIM explained (California Health Care Foundation)
• Alternative Payment Models (Centers for Medicare & Medicaid Services)
• Technology Hub, a CCI program that helps organizations vet, pilot, evaluate, and spread innovative digital health solutions targeting Medicaid markets and historically underinvested communities

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🎙Podcast production services by Wayfare Recording Company.

© 2023 Center for Care Innovations. All Rights Reserved.

There are two sides of referral management to handle – inbound and outbound. In light of the growing need to adopt a low-touch approach that taps into technology while also leveraging workforce skills, Altura Centers for Health sought to make the referral management process as self-sustaining and automated as possible. To better tackle their large volume of referrals, they’ve begun to implement a new referral system that manages most of the inputs, thereby freeing up more staff from the inbound referral processes. We hear from Arnie Reynoso, chief information officer at Altura Centers for Health, as he talks about their efforts to minimize the need for staff involvement in referral management, from referral to specialist review, scheduling, and ultimately, patient care. 

Learn more about the people, places, and ideas in this episode: 

• Arnie Reynoso, Chief Information Officer at Altura Centers for Health
• HealthViewX - helping healthcare providers orchestrate care continuum pathways and enhance the experience of patients, providers, and communities
• Technology Hub, a CCI program that helps organizations vet, pilot, evaluate, and spread innovative digital health solutions targeting Medicaid markets and historically underinvested communities

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🎙Podcast production services by Wayfare Recording Company.

© 2023 Center for Care Innovations. All Rights Reserved.

What is equity-centered community design? This transformative concept focuses on centering the voices and decision-making power of individuals with lived experience, who Creative Reaction Lab refers to as “living experts.” It also calls on human-centered design experts and others to use their leverage, access, and influence to support and amplify community voices. In this session, CCI’s Chris Conley chats with Hilary Sedovic, a systems thinker and former learning & education director at Creative Reaction Lab. Sedovic, who calls herself a “redesigner for justice,” sheds light onto the key role that design allies have in empowering living experts. Creative Reaction Lab emphasizes building quality relationships, humility, and embracing a collective investment in community well-being in order to move towards greater equity and inclusivity in design. Learn how this type of civic engagement and the redesigning for justice movement can move us to reshape the narrative -- creating a just world through authentic collaboration and community-centered approaches in the design process.

Here’s where you can learn more about the people, places, and ideas in this episode: 

• Hilary Sedovic, Systems Thinker | Redesigner for Justice | Pragmatic Idealist
• Catalyst, CCI’s design thinking training program
• Creative Reaction Lab, building a youth-led, community-centered movement of a new type of Civic Leader: Redesigners for Justice.

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🎙Podcast production services by Wayfare Recording Company.

© 2023 Center for Care Innovations. All Rights Reserved.

What does "community" mean to you? We chat with Anna Radoff, a diversity, equity, and inclusion (DEI) lead strategist at Justice Informed, a social impact consulting firm. Anna helps us unpack what it means to engage stakeholders, invest in relationships, share power, create intergenerational change, and more!

Here’s where you can learn more about the people, places, and ideas in this episode: 

• Anna Radoff, a diversity, equity, and inclusion (DEI) senior strategist at Justice Informed
• Catalyst, CCI’s design thinking training program
• Justice Informed CEO Xavier Ramey, who we interview  in Episode 37, Changing the Face of Expertise

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🎙Podcast production services by Wayfare Recording Company.

© 2023 Center for Care Innovations. All Rights Reserved.