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Vital Signs


Vital Signs

Summer 2010

Healthcare Reform


High on the Agenda for New Vice Chancellor for UCLA Health Sciences

VS-Summer10-Healthcare ReformA. Eugene Washington, M.D., M.Sc., arrived at UCLA in February to assume the leadership of UCLA Health and the David Geffen School of Medicine at UCLA. Before coming to UCLA, Dr. Washington was executive vice chancellor and provost of UC San Francisco (UCSF). Prior to his tenure at UCSF, Dr. Washington worked for the Centers for Disease Control and Prevention in the U.S. Public Health Service. He is a respected clinical investigator and health-policy scholar. He spoke with Vital Signs about UCLA’s role in the ongoing discussion of healthcare reform.

What is UCLA’s role in contributing to the direction of healthcare reform?

When you look at it very closely, the healthcare reform bill that was passed in Congress and signed by President Obama creates a framework within which many different groups and academic healthscience institutions can come together to help orchestrate this movement that will dramatically change the healthcare-delivery landscape in this country. And I believe that we at UCLA will, in fact, be an active participant in that small group that will be helping to shape the future of healthcare in the U.S. It will be the academic health-science institutions like UCLA that will develop the demonstration projects and pilot test various models to determine which are the highestquality programs that add the best value at the most reasonable cost.

What are some examples that we may look to from our own experience at UCLA?

When I think about the remarkable excellence we have already achieved in delivering the highest-quality care, as well as the opportunities for improvement still before us, I think of them in three dimensions. First is what goes on inside our hospitals, particularly related to innovations needed to continue improving quality of care. In this area, UCLA is at the forefront of a very elite group of institutions that are contributing important advances.

VS-Summer10-Dr. Washington On Healthcare ReformOne highlight of our approach is our project to improve the patient experience. As a result of engaging our staff and physicians in developing this program, UCLA now ranks in the 96th percentile in customer satisfaction compared with all hospitals in the nation. This effort also underscores our unwavering commitment to patient safety and patient-centered care.

So an element of our contribution to shaping the future of healthcare is establishing mechanisms to effectively disseminate innovations like these beyond UCLA in a timely manner. Such diffusion can involve simply telling our colleagues at other institutions about our experiences, or sharing them with the world through presentations and publications.

What is another dimension of your view of the changes that need to come?

The outpatient setting. Our UCLA Faculty Practice Group has about 76 office practices concentrated near our hospitals in Westwood and Santa Monica. While we are also providing the highest-quality care in our practices, the opportunity before us is to continue to elevate this quality, in the same manner that we’ve done in our hospitals. We are currently pursuing this goal by promoting quality and service metrics and standards of excellence that are uniform across all practices, and performance improvement where we fall short. In doing so, we are positioning ourselves to be a leader in identifying best practices for the outpatient setting and to play a role in continuing to shape future best practices for us and for others.

And the third dimension involves what I see as one of the ultimate objectives of health reform — more focus on population health. At UCLA, we have a health system that incorporates both our inpatient hospitals and all of our outpatient practices to provide our patients direct care of exceedingly high quality. With a successful model of integrated outpatient and inpatient care, we are also well positioned to become a health system in the years ahead whose reach extends well beyond the care we are providing in our hospitals or clinics. The aim here is to augment our high-quality, patient-centered care, which will remain indispensable, with additional programs and interventions that we know promote health and prevent disease.

VS-Summer10-Dr. Washington on Healthcare ReformThere is so much emotion, as well as confusion and misinformation, surrounding the healthcare discussion. What can we, as a school and as a healthcare system, be doing to not just look at the best delivery methods for healthcare, but also to help inform the debate about reform?

It is an area where I think we can do much more. At UCLA we should be thinking about the messages and the information and knowledge that we want to help convey in this region about healthcare reform. And we should develop a more coordinated effort so that we now are helping to educate the public on these issues. The objective would not be for recruitment or to generate more patients; it would be because we are a leader, and we have amazing intellect and expertise in this area. Therefore, we should be directing it toward the public discussion, as a public service, to educate our community. I have to admit, the voice of the academic community has been too muted on this issue, and we should work to turn up the volume.

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