Did you Get your Colon Screened?

As we near the close of Colorectal Cancer Screening Awareness month, I'd like to take a moment to celebrate our Regional Cancer Screening Consultant, Anita Joshua.  Anita stepped outside of her comfort zone as the Senior Consultant of our Regional Proactive Panel Management program and took over the responsibilities of leading the Cancer Screening initiatives in late 2010.  Over the last year she has immersed herself in this additional role, attempting to learn as much as possible about breast, cervical, and colon cancers.  She has gone on a few site visits to observe successful practices, visited the regional Laboratory to say "thank you" to all of our lab staff who are processing those important results, and holds regular meetings with the local leads over each initiative. 

For Colon Cancer awareness month Anita arranged for videos to be played outside our cafeteria entrance at the Regional Office, had signs hung inside our building as well as above the parking structure, and even set up shop every Thursday from 2-4 pm inside our Employee Wellness Center reviewing care gaps with interested employees/members.  As Anita described it "there was a LOT of talk about POOP!"

Those two hours she spent each Thursday resulted in 32 people coming in to see if they were due for a screening, 6 of which WERE due and received a FIT kit (after a demonstration by Anita on how to complete the screening).  That is 32 people more aware of when they personally need to be screened/rescreened and 6 potential lives that could be saved.  Way to go Anita!!!

I'm Pretty Sure It's a Brain Tumor

I've suffered from migraine headaches for as long as I can remember, so I'm use to the routine of taking some Norco and locking myself in a dark room or going to urgent care to get a Toradol injection.  But for the past month I have had this constant headache on the left side of my head accompanied by this intermittent pressure of what I can only describe as a balloon slowly filling and then releasing behind my left eye.  After some gentle nudging from my staff and a big shove from my chiropractor who usually has no problems getting my migraines back in control, I went in to the doctor today to get it checked out. 

When Glendale Clinic Medical Assistant, Mae Wong, asked me what my chief complaint was I told her "I'm having constant migraines and I'm pretty sure I have a brain tumor".  Mae just smiled and said without making fun of me in any way, "Well... let's get your blood pressure and get you in to the see the doctor."  Wouldn't you know my blood pressure, which has been perfectly normal for the past year, was elevated.  Mae said "Your blood pressure is a little elevated.  I'm going to ask a few questions and set up the room then we'll take it again to see if it settles down."  Then, Mae asked me a couple questions about my asthma, exercise, tobacco use, etc.  Questions which are all part of our Southern California Proactive Care intake process. Some people complain that the POE intake process slows the staff down and that it takes too long, but I swear to you, Mae went through everything in about a minute and a half.  A minute and a half to address actions that could possibly save a life one day... totally worth it.

After repeating my blood pressure (which was now nice and normal) Mae took me back to the exam room where she opened the EMR and signed on to my chart, securing it on her nursing notes (Computer Ready), she asked me to sit on the exam room bed (Patient Ready) and said the doctor would be in the room in just a moment.  When she left, I snapped a few pictures to show you how the Room Ready concept is applied as well.

No big deal right?  Why wouldn't your doctors nurse ask you about your asthma, exercise, tobacco use, repeat your blood pressure when elevated and set up the room for the visit?  Well... to start, this wasn't my PCP or my PCP's nurse.  This was a same day urgent appointment with a doctor from my doctors "team".  What came across loud and clear was that we do Proactive Care for every patient at every visit - no matter who or where you are.  Mae didn't know me from Adam.  She didn't know I ran the Proactive Care program for the region (which was actually refreshing) and she didn't know I was observing her every move so I could blog and tweet about it later.  She saw me as a patient.  No... scratch that... she saw me as her patient who, though possibly a bit over-dramatic, was suffering from chronic migraines.  Her smile was comforting, genuine, and appreciated.

Perhaps I was a bit influenced by the Toradol injection I just received and the relief of knowing a CT would be done soon, but I left that visit thinking, "if this is how all our patient's feel at the end of their care experience with us, we really can become the provider of choice."  And that, my friends, gives me hope and a sense of pride. 

Colorectal Cancer Awareness Month

March is Colorectal Cancer Awareness Month and this month's refresh of the Care Stories blog features three members whose use of at-home test kits led to early identification and treatment of colon cancer. These stories shine the light on KP's focus on prevention, excellent care, and ease and convenience. Check out the stories via the links below:  

Greg Mathis grateful to his care team for ordering screenings

Dale Gordon’s appointment for a swollen knee leads to life-saving screening

Carl Stotler credits a home test kit with saving his life

Colorectal Cancer Screening Can Save Your Life!!!

Screening Recommendations

Colorectal cancer screening is strongly recommended for all asymptomatic,  average-risk adults aged 50 to 75. Any of the following tests and intervals are  acceptable options for colorectal cancer screening:

• Fecal immunochemical test (FIT) every year ^2,3
• Flexible sigmoidoscopy every 5 years (with or without FIT)
• Colonoscopy every 10 years

Leading With Heart in Rancho Cucamonga

Yesterday our Southern California Complete Care team and our Rancho Cucamonga leadership and staff hosted a rare knowledge exchange site visit with our Northern California counterparts.   After a morning session of sharing technology, innovations, and future state ideas, we had an opportunity to take our NCAL partners on a tour of the Rancho clinic where they met staff members who were living the Complete Care - Proactive Care philosophy.  There was not ONE person we spoke with from the clinic who did not mention POE as part of their workflow. (Yes... I was beaming with pride from ear to ear!) Their medical assistants walked us through a couple patient intakes in both Pediatric's and Adult Primary Care and as they did, they explained (with clear understanding the importance of their role) how important it was to try and close the care gaps at the point of care.  During our walk through the staff showed us how they demonstrate to the patient how to use the FIT kit for colorectal cancer screening, prepare the patient for foot exams - remembering to set out the monofilament tool, and set up the room with any necessary equipment needed for that patient according to their chief complaint and care gaps. "Our goal," said Blood Pressure clinic Medical Assistant Clarivel Baltazar, "is to try and close each person's care gap BEFORE they leave our clinic."  This sentiment was reiterated by each care team member we met; from nurse triage to primary care to pediatrics and optometry. 

One of our NCAL visitors asked me if this response was normal.  I can say from doing countless site visits, that while this isn't always perfectly executed, I can say comfortably that "yes, for the most part, this is the culture you would find at most of our clinics."  Her next question was "How?"  "How do you get everyone to live and breathe the same message?"  That answer was easy.  "Leadership"  While the message begins with our regional leaders, it is internalized and shared by our local leadership teams from the Medical Directors and Medical Group Administrators, out to the clinic chief's and administrators.

Standing next to me, Dr. Nolan Chang, Family Medicine Chief at Rancho Cucamonga told us "If we all do POE at every visit, our patient's are healthier and the workload is lighter."  "Honestly though" he said, "we couldn't do this without our support staff being engaged in improving our patient's lives."  Dr. Chang and his Department Administrator, Beth Curry, were quick to highlight some of the workflow improvements that came from their UBT's, proving that the input from their staff was equally valued.

My take-away...

Each time I visit Rancho Cucamonga, or any outlying clinic in the Fontana service area for that matter, I always leave with the same impression.  They truly are service oriented.  They serve each other so that together they can serve the patient.  They care about each other and together they care about our patients.  I've talked about "leading where you stand" in other blogs and, to me, the Rancho Cucamonga team embodies that philosophy.  From the security guard who starts up the mammography machine in the morning so the clinic doesn't fall behind on mammogram's waiting for the system to start up, to the retinal photo technician who grabs patient's before or after their appointment to complete their retinal photo when due, to the registration staff who schedule appointments for mammogram's or pap's, to the medical assistants and LVN's who take the time to prepare the room, the patient, and the computer for every visit, to the RN's who roll their cart up to the module to teach a new diabetic patient how to do an insulin start, to the physician's and PA's who will try their best to close each care gap without grumbling about falling behind, and to the leadership team, like Dr. Mark Bai, Nolan Chang, and Beth Curry, who remembers to not just share the message, but celebrate the successes of their team.  This is the Complete Care philosophy taken to heart and put in to action for every patient, every place, every time.