Issuu

INNOVATIONS

Celebrating the Riverside University Health System Team’s Commitment to the Health of Riverside County

4TH EDITION: CONNECTING THE DOTS | SUMMER 2022

The theme of this issue of Innovations is ‘Connecting the Dots,’ which highlights the dedicated and innovative spirit of every team member across Riverside University Health System (RUHS) and our partners. When I started at RUHS more than seven years ago, we organized our health system around four strategic pillars, including a pillar tightly aligned to the theme of this issue, “integrated delivery network.” To best serve our patients and help them achieve the best outcomes, we knew we needed to strengthen our connections within our system, with other county agencies and with many community partners. We started our focus within our health system, Public Health, Clinics, Behavioral Health, the Medical Center, Community Health Centers, and Correctional Health Departments with the aim to improve the outcomes for all we serve. That transformational change still requires focused effort around organizing and improving access to services, addressing the social determinants that directly impact health outcomes, and connecting people to all partners and services uniquely needed by each person. This edition offers you the opportunity to learn more about how RUHS regularly connects to key partners to improve outcomes for the people we serve at all stages in life and with diverse needs; and how, together, we wrap services around people in our communities to make a difference. We cannot think about connections without special attention to our efforts to connect person-to-person. Dr. Leung’s article on loneliness captures that perspective and demonstrates an understanding of what the team is ultimately trying to accomplish. Mahatma Gandhi once said, “In a gentle way, you can shake the world.” At RUHS we are committed to making connections at both the system and human level, knowing that approaching health from that perspective is how we truly make a difference.

Zareh Sarrafian, MBA Assistant County Executive Officer

FOURTH EDITION

CONTENTS THE IMPORTANCE OF SOCIAL CONNECTEDNESS

RUHS & FIRST5 COLLABORATION PROVIDES CARE FOR FAMILIES

PUBLIC HEALTH PROGRAMS PROVIDE LINKAGES TO CARE

50 YEARS OF DEVELOPING COMPASSIONATE CAREGIVERS

PARTNERSHIP SUPPORTS AT-RISK CHILDREN IN RIVERSIDE COUNTY

LEADERS IN DELIVERING AN INTEGRATED SYSTEM OF CORRECTIONAL HEALTHCARE

EXPANDING BEHAVIORAL HEALTH CARE DURING THE PANDEMIC

MAT: LINKING SUBSTANCE ABUSE PATIENTS WITH BETTER CARE

BLACK INFANT HEALTH PROGRAM HELPS WOMEN HAVE HEALTHIER BABIES

CLOSING CARE GAPS WITH THE HEALTHY PATIENT OUTREACH PROGRAM (HPOP)

CAL AIM: ENHANCED CARE MANAGEMENT FOR PATIENTS WITH COMPLEX NEEDS

PROVIDER SPOTLIGHT: SIDDIQA NAWAZ

RUHS AWARDS & RECOGNITIONS

MOLINA HEALTH SUPPORTS RUHS – SAFE CLINIC

RUHS TEAMS UP WITH LIFESTREAM DURING BLOOD SHORTAGE

RUHS INNOVATIONS

FOURTH EDITION

THE IMPORTANCE OF SOCIAL CONNECTEDNESS BY DR. GEOFFREY LEUNG

In 2017, US Surgeon General Vivek Murthy recognized loneliness as a new and emerging silent killer of Americans and declared that loneliness had become a public health “epidemic.” Research by Psychology Professor Julianne Holt-Lunstad at Brigham Young University suggested that loneliness has as great if not greater an impact on health than smoking or obesity. And many experts agree that the most important cause of death among older Americans is neither heart disease nor cancer, but rather loneliness or social isolation.

ties — including retirement, transportation barriers, and disability — can ultimately result in both decreased quality and length of life.

Anecdotally, we have all heard stories about elderly individuals whose death closely follows the death of a spouse. This “widower effect” is well documented in scientific literature and appears to exist across a variety of populations, cultures, and countries. In particular, a recently widowed individual has a much greater chance of dying unexpectedly during the 6 months immediately following the loss of one’s spouse. It is as if the widowed individual has died from a “broken heart.”

Interestingly, when the COVID-19 pandemic first began in the spring of 2020, part of our initial response as a society was “social distancing.” And while this reduced the transmission of COVID-19, it may have also unintentionally impacted relationships, friendships, family activities, and overall social connectedness, ultimately resulting in a society that — at least temporarily — collectively felt even more socially isolated.

Perhaps less dramatic but more perilous than the widower effect is the social isolation that so many of us experience on a day-to-day basis — that is, teenagers struggling to fit in at school, overly devoted caregivers who have foregone time with friends to care for loved ones, and older adults whose social circles have become suddenly limited following recent illness. In fact, any life events that unexpectedly disrupt one’s social circle and social activi-

RUHS INNOVATIONS

While social isolation can be harmful to one’s health, social connectedness can promote healing, resilience, and longevity. In fact, people who feel that they have reliable confidants, good friends, and / or strong social support may have a 15-year life expectancy advantage over those who do not.

Now, as we rediscover a new sense of normalcy, we increasingly appreciate the vital role that social connectedness plays, not only in healing and recovery, but also in creating resilient and vibrant communities. So, if you can, please take a moment to nurture your relationships. Call a friend, reconnect with family, meet someone new. Your health deserves it.

RUHS & FIRST5 COLLABORATION PROVIDES CARE FOR FAMILIES

BY DR. RONALD JOHNSON, WITH JUSTINE GUIDRY For more than two decades, First5 has emphasized how significantly a child’s first five years can impact the outcome of their entire life. Recognizing that prenatal care and health in utero can significantly impact those first five years, First5 Riverside County provided a $6.3 million grant to RUHS Foundation to establish a transformative healthcare experience for women and their babies. In mid-2019, Dr. Bryan Oshiro, Dr. Ronald Johnson, and Riverside University Health System Foundation presented their vision to First5: for every patient experiencing a high-risk pregnancy in Riverside County — which spans more than 7,000 square miles — to have access to high-quality care necessary for a successful pregnancy and birth. The vision aligns perfectly with the mission of First5, as a healthy mother and baby tremendously impacts the next five years of that baby’s life. In the eight months that followed, Dr. Oshiro, Dr. Johnson, Nicole Peterson Orr of RUHS Foundation, First5 Executive Director Tammi Graham, and Riverside County Children and Families Commission Regional Manager Piera Causley collaborated to create a comprehensive plan for HeRCARe before it was approved by the First5 Riverside County Commission. Thanks to the grant and the program’s integration of medical centers, clinics, physicians, and various social service programs, the vision for HeRCARe (High-Risk Care Access & Resources Program) is already a reality. In the past year, more than 250 women who would have previously had to jump through hoops to get the right care during their pregnancy were able to easily access the services they needed. Before HeRCARe, a pregnant patient with a history of addiction who lived in Indio might have been referred to Dr. Oshiro, the only full-time Maternal Fetal Medicine (MFM) Provider in Riverside County, located in Moreno Valley — more than an hour away without traffic. Now, with HeRCARe in place, that same patient can have her appointment with Dr. Oshiro’s ultrasound technician closer to home, with Dr. Oshiro attending via teleconference on a high-resolution monitor. Dr. Oshiro can see the ultrasound in real-time and speak

directly with the patient. “We’ve done patient surveys and the feedback is very positive,” says Dr. Oshiro. With the ultrasound technician there with them, patients say it feels personal.” The services don’t stop with medical appointments. Bilingual social service practitioners work with the patient and physicians to make sure appointments are on track and that the patient is receiving other services that might be available such as food assistance or counseling. Providing this quality care and making it easily accessible requires the integration of a variety of services and the collaborative efforts of hundreds of people. “We’ve found that the most successful method of integrating with other providers has been getting on the road to meet face to face to talk about our goals,” says Dr. Johnson, Chair of Obstetrics and Gynecology at RUHS. Medical centers and clinics have collaborated to serve patients through a coordinated system of care. To provide wraparound services for mother and baby, HeRCARe has built partnerships with programs such as Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Black Infant Health (BIH), various First5 programs, services available via Riverside County Department of Public Social Services (DPSS), and more. More patients means more appointments, so First5 provided four years of bridge funding for RUHS to hire another Maternal Fetal Medicine Specialist, Dr. Sarah Smithson. The grant also includes funding for an ultrasound technician, a social services practitioner, and program manager. This robust start will keep the program sustainable long past the conclusion of the grant period. Women can access HeRCARe services at RUHS Community Health Centers in Banning, Corona, Hemet, Lake Elsinore, and Moreno Valley. Clinics in Blythe, Jurupa, and Palm Springs will open over the course of the next year, expanding the program’s reach. The program anticipates serving more than 300 women in 2022, and that number will only grow as the program progresses, creating a lasting impact on the outcomes of children, mothers, and their families for years to come.

FOURTH EDITION

Visit www.ruhealth.org/hercare for more information.

RUHS INNOVATIONS

PUBLIC HEALTH PROGRAMS PROVIDE LINKAGES TO CARE

BY JESSICA CUEVAS, WITH CONTRIBUTIONS FROM: WENDY HETHERINGTON, DIANNE LEIBRANDT & ANDREW JIMENEZ From 2008 to 2017, Riverside County saw a 63% increase in overdose death numbers and rates — from 11 people per 100,000 residents to 18 people per 100,000 residents. In addition to deaths, the county experienced a 10-year increase in overdose-related emergency department visits and hospitalizations. Addressing the Problem: RODA Riverside University Health System - Public Health (RUHSPH) Riverside Overdose to Action (RODA) is integrated into RUHS – PH’s Epidemiology and Program Evaluation Branch with the purpose to enhance surveillance of overdose morbidity and mortality and to use enhanced surveillance data to guide overdose prevention efforts. RODA Partnerships Partnerships with health systems and other partner organizations with experience in planning and implementing strategies to address opioid misuse, use disorder, overdose and opioid-related harms, or working with high-risk populations, have been essential in the success of RODA. Through these partnerships, RODA has had many notable successes that demonstrate the concept of data to action.

Enhanced Overdose Surveillance Public Health partners with Riverside County Sheriff Coroner’s Bureau (RSO) and Emergency Medical Services (EMS) as part of RODA. A Certified Crime and Intelligence Analyst from RSO is co-located within RUHS – Public Health, facilitating the collection, analysis, and interpretation of coroner’s reports, including toxicology and autopsy. EMS and RODA disseminate monthly reports that provide an in-depth overview of suspected overdoses, Narcan administration, and the types of drugs mentioned in overdose calls. For up-to-date data on overdoses in Riverside County, see the Riverside County Overdose Data Dashboard. This GIS-driven dashboard displays data on fatal overdoses, opioid-related emergency department visits, and opioid-related calls to poison control. Interactive maps allow users to view more detailed demographic data such as gender, age, and race/ethnicity (when available). Prevention To address an increasing number of overdose deaths and fill critical gaps in local knowledge, Riverside County

900

800

700

600

500 400

300

200 100

2016

2017

2018

2019

Overdose Fatalities 8

2020

2021*

Overdose Deaths per 100,000

Number of Overdose Deaths

NUMBER OF OVERDOSE DEATHS IN RIVERSIDE COUNTY

Rate FOURTH EDITION

was among the first local jurisdictions in California to establish an Overdose Fatality Review (OFR). The mission of the OFR team is to improve countywide overdose epidemiology and recommend initiatives to prevent new cases of drug addiction, overdose, and death. Targeting At-Risk Groups One of Riverside Overdose to Action (RODA) primary target populations includes pregnant, postpartum, or teenage mothers with a history and/or at-risk for substance use/overdose. RODA’s Public Health Nurses (PHNs) and Maternal, Child, and Adolescent Health (MCAH) branch created programs to address the unique needs of this population. These branches provide case management services that connect those at risk with medical and mental health as needed. Training programs for healthy parenting/families are also provided. Youth Outreach To reach our youth, RODA developed the Overdose Awareness & Prevention Program (OAPP). Using the This is Not About Drugs (TINAD) curriculum, OAPP trains middle and high school students on building resiliency, developing healthy coping skills, and the dangers of prescription drug misuse. Additionally, RODA staff collaborates with RUHS – Behavioral Health’s Substance Use and Treatment Program to create a referral process. After students complete the CRAFFT screening tool during the training, moderate to high-risk students are referred to Behavioral Health Specialists and/or school counselors while low-risk students are referred to Friday Night Live program. Over the 2021–2022 school year, OAPP completed 45 trainings for 1,743 students. RODA also developed a media campaign on the risks of opioid misuse and harm reduction strategies for youth and parents. This includes digital ads and a youth focused landing page with resources on signs and symptoms of overdose, strategies for responding to an overdose, and resources for substance use help. For more information, visit the campaign website at: https://www.ruhealth.org/ public-health/riverside-overdose-data-action

RUHS INNOVATIONS

Enhancing Awareness Collaboration between RODA and community-based organizations such as the Inland Empire Harm Reduction (IEHR) Coalition and Starting Over, Inc. has been crucial in increasing awareness of overdose prevention. IEHR and RODA have hosted more than 12 bystander naloxone trainings on how to recognize an opioid overdose and respond with naloxone. Starting Over, Inc. has hosted naloxone trainings for their staff and members, and they have also provided substance use and overdose prevention resources and linkages to RODA’s Public Health Nursing overdose prevention case management program. Starting Over, Inc. is uniquely familiar with one of RODA’s target populations, as they provide housing and re-entry services for under-resourced communities, including individuals experiencing homelessness, formerly incarcerated populations, and those who have experienced adverse childhood experiences (ACEs) that are at greater risk of a drug overdose. In July 2021, the Riverside County Board of Supervisors launched a Fentanyl-abuse awareness campaign and multidisciplinary committee to inform the public of the dangers of Fentanyl and the risks of opioid-related overdose. More recently, RUHS – Behavioral Health extended the partnership with RODA to expand our overdose prevention programming. This expansion will allow us to increase training opportunities, provide linkages to care, and outreach to populations in our jurisdiction who may be at risk for substance use or overdose. Effective overdose prevention requires a multi-disciplinary approach, strong and invested collaboration, data sharing, and data-driven evidence-based practices. These coordinated efforts prevent new addictions, treat existing addictions, and stop overdose deaths. RODA will continue to expand and create a strong network of support within community and government programs across the county to effectively address opioid use and misuse.

50 YEARS OF DEVELOPING COMPASSIONATE CAREGIVERS BY LENORE GALLUCCI STEVENSON

For generations, highly skilled health care professionals and support staff at RUHS – Medical Center have provided exceptional, state-of-the-art care to the county’s diverse populations. Our mission is to improve the health and well-being of our patients and communities through our dedication to exceptional and compassionate care, education, and research. One way that RUHS meets this mission is through the residency programs. During the three-year RUHS/ UCR Family Medicine Residency (FMR) program, residents receive training that prepares them to provide excellent patient care, but the program goes beyond developing just clinical skills. Rather, the residency program offers an environment that focuses on compassionate caregiving and leadership, empowering them to become health advocates within the community and role models to future physicians. From 1971 to Now When RUHS became a teaching hospital in the early 1900s, physicians and head nurses worked as instruc-

tors. Then, sometime in the 1930s, the National Youth Administration began training nurses, with the intern training program beginning around 20 years later. This continued to progress for another 20 years, with the community-based FMR Program beginning in 1971. By 1982, it was one of the first of its kind to gain accreditation in California from the American Academy of Family Physicians (AAFP). The RUHS/UCR Family Medicine Residency program, which is accredited by the Accreditation Council for Graduate Medical Education (ACGME), has proven to be very successful — since its inception, more than 300 family physicians have graduated from the program. Originally, the program had six resident students at the first-year, second-year, and third-year levels. In 2010, the program grew to 12 residents per year at each level. Today, the program functions with a Family Medicine Chair and Vice Chair. Along with a program director, FMR has a program coordinator with two assistant coordinators, 10 full-time faculty and a full-time clinical psychologist.

FOURTH EDITION

“Many changes have happened in the past 14 years that I have had the privilege of working with residency program,” said former program director Dr. Parastou Farhadian. “Mostly a lot has been changed fromthe time the FMR program started. There have been medical center location changes, academic sponsorship changes, the name of the program changed, we’ve had several program directors, we’ve expanded the faculty complement, and the curriculum has changed. But something that has never changed is the mission of our program, because we live by our mission.” Addressing Ethnic and Racial Inequities When Dr. Adolfo Aguilera began his tenure as program director in 2010, he sought to recruit more underrepresented minorities (URM) to “help fill the gap of ethnic and racial inequities that existed within our health care system.” As a result, the program held a 30–40% rate of URM. According to Dr. Aguilera, “this representation really helped serve our large Latino and African American population in a more culturally sensitive and linguistic appropriate manner. This was further solidified by our high rates of placing our graduating residents in areas of unmet need.” In fact, 75% of graduating residents stayed in Southern California and 50% stayed within the Inland Empire. Today, the RUHS/UCR Family Medicine Residency Program still strives to train family physicians who come from diverse backgrounds, helping these learners become competent independent family physicians who are highly skilled at providing comprehensive and patient-centered care. “Our Program aims to produce Family Physicians who are proficient community leaders and healthcare advocates for all patients and their families, most especially the underserved communities,” said Farhadian. Clinic First Model Traditionally, residents spend one to three half-days per week in a family medicine clinic and rotate between outpatient and in-patient care monthly. This model makes it difficult to train physicians to provide comprehensive and patient-centered care. Alternatively with the Clinic First Model, which the RUHS FMR program follows, residents rotate on one- to twoweek mini-blocks. This way, residents can avoid being absent from the continuity clinic for long periods of time, giving them the opportunity to book most patients with the same primary care physician resident and the same primary care team. Thus far, the response to the Clinic First Model has been excellent. Residents have expressed increased wellness due to better ability to provide continuity of care and better control of their schedules outside of the clinic and hospital. Our patients are happy to have a long-term re-

RUHS INNOVATIONS

lationship with their primary care physician, and better access to care. Research Projects As a component of our curriculum, the residency program requires residents to actively participate in scholarly activities. While it is expected that residents will participate in research throughout their three years of residency, they begin a formal research project on an approved topic during their second year of residency. All residents are required to complete and present their original research project at the end of their third year at both the UCLA Research Day Conference and the Inland Research Forum. Residents are also encouraged to submit their projects for presentation and or publication at professional regional and national meetings or in peer-reviewed journals. In the past few years, research projects have included clinical projects, health care systems research, patient education research, case reports, and quality improvement projects. Several residents have presented their research at the Inland Empire FMR Exchange. During the past five years, these projects and presentations have won awards at this annual research forum. Last year our residents took first place at our own RUHS research symposium and placed top 3 in our regional PREMIER research forum. And some go on to present at state and national conferences. “We trigger curiosity within our residents through research and scholarly work,” says Dr. Aguilera. “It has always been an essential part of our program. Not only does research align with part of our mission statement, it also helps form investigation to further our minds and approach to patient care. Being at the forefront of medicine and creating resourceful physicians that will integrate their work into their practices will benefit our institution and impact our community in a positive manner.” “We cherish diversity, we believe in inclusion and cultural sensitivity, and we live it in our program,” says Dr. Aguilera. “In our work family, we all come from different backgrounds, different schools, and even different countries. Last time I counted, we share over 20 different languages and many of us our bi-cultural and/or bilingual. Our faculty also bring unique expertise to the program — from Sports Medicine, Palliative Medicine, Geriatric Medicine, Community Medicine, Wellness, Addiction Medicine, to Population Health and Quality Improvement.” All of this allows not only for a rich learning environment, but an opportunity to connect deeply with our patients and a legacy for future residents.”

FOURTH EDITION

PARTNERSHIP SUPPORTS AT-RISK CHILDREN IN RIVERSIDE COUNTY BY DR. CHAD VERCIO

Nearly two years ago, RUHS’s Department of Pediatrics began to establish a connection with the county’s Department of Public Social Services (DPSS), which manages many of the challenges surrounding foster care. This relationship has grown and has become a foundation for two important initiatives within RUHS’s Pediatric Clinic at the Medical and Surgical Center, as well as RUHS’s Community Health Centers.

ment and DPSS, we were able to develop a process to “fast track” children that are taken into custody by CPS. Social workers can now get a same-day appointment, making these situations substantially simpler. The initiative not only decreases the likelihood that a child is exposed to COVID or other illnesses during an avoidable emergency department visit, but it also decreases the number of unnecessary emergency room admissions.

The first initiative arose when RUHS’s Pediatric Ward team noticed that occasionally patients were admitted from emergency departments in situations that did not actually require an admission. For example, a child who has a chronic medical condition might need to be removed by Child Protective Services (CPS) because their home is deemed unsafe, but a foster parent is uneasy about accepting the child without a medical clearance. As a result, CPS brings the child to our emergency department to gain medical clearance, but many times the emergency department isn’t able to provide it or isn’t sure if the child needed to be admitted for their chronic condition.

The second initiative that came out of RUHS’s collaborative discussions with DPSS was the development of a clinic focused on adolescents who have been or are at risk to be commercially sexually exploited. Both organizations felt that these children should receive more comprehensive care than the typical pediatric practice provides.

In other situations, potential foster parents want to be sure a child with a chronic diagnosis is stable enough to bring into their home and doesn’t require a different level of care. The child may not necessarily need to go to the emergency room, but DPSS may need to get them an urgent appointment for something such as diagnosing asthma, well-controlled seizures, or another diagnosis that requires medication — so they can quickly be placed with a foster parent. Unfortunately, CPS workers were often unable to get urgent appointments in these situations. After discussions to establish the needs, possibilities, reality, and expectations of both the emergency depart-

RUHS INNOVATIONS

While the Riverside County Child Assessment Team (RCCAT), a wonderful resource for the county, can evaluate adolescents and children in cases of abuse, it is not currently geared for following patients on a long-term basis. Due to this limitation, the RCCAT team doesn’t provide comprehensive care for these children. As such, a new clinic has been developed for this patient population. The clinic utilizes the skills of our forensic pediatricians and will also have a licensed clinical social worker for care management support as well as behavioral health. This endeavor has involved connections between our Pediatric Clinic, Dr. Sophia Grant, the medical director of RCCAT, DPSS, and Inland Empire Health Plan (IEHP). It’s a prime example of how different entities across the county can come together to support a child who may have otherwise gone without proper care, providing them with an opportunity to live a healthy, productive life.

LEADERS IN DELIVERING AN INTEGRATED SYSTEM OF CORRECTIONAL HEALTHCARE CONTRIBUTORS: DR. MICHAEL MESISCA, DR. THOMAS MINAHAN, DR. TERRY FILLMAN & SHEENA PATEL

Successful inmate care takes tremendous collaboration, and in Riverside County, it involves efforts from the Sherriff’s department, Riverside Universtity Health System (RUHS) Correctional and Behavioral Health, RUHS –Medical Center and Specialty teams, healthcare partners and leaders with Vituity, and support from RUHS’s Public Health leadership. Over the last several years, Riverside University Health System’s Correctional Health Services (CHS) have taken major steps toward creating a better system of care for individuals incarcerated in our county jails. Correctional and Behavioral health leaders have worked to provide fiscally responsible and quality healthcare by improving clinic efficiency and throughput, focusing on utilization management, taking on continuous quality improvement (CQI) projects, and holding joint leadership meetings at each jail with the Sheriff’s department. Those efforts have proven effective. In 2017, Riverside County jails became the first in the state to receive National Commission on Correctional Health Care accreditation. In June 2021, during the pandemic, the jails were reaccredited at all five adult sites. With four adult jails spanning a massive county, more than 60,000 individuals booked into the jails annually and approximately 3,800 housed at any time, many inmates enter the correctional setting with chronic health conditions and/or other healthcare needs. CHS is also seeing an increasing aging population who often need extensive care. Inmates in the jail setting that do not require hospitalization are provided healthcare by CHS physicians, nurse practitioners, dentists, and nurses. Here are some specific areas in which CHS is making excellent strides in caring for Riverside County inmates: COVID-19: Riverside jails were among the first in California to do widespread onsite testing. To date, there has only been a single COVID-related inmate death, and we continue to offer monoclonal antibody treatment to eligible inmates. Positive COVID rates in the jails remained below 2.5% throughout most of the pandemic, even when community rates soared upwards of 25%. The CHS

leadership team has given national lectures and published an article (with an update pending) on the massive and highly successful efforts to minimize the impact of COVID-19 in the county jail system. Dental: Dental procedures include dental X-rays, fillings, extractions, and denture repairs. Our dental team completes more than 2,300 in-house visits each year. Telemedicine/On-Site Ortho/Optometry: To enhance timeliness, CHS has implemented on-site services. Each site has dedicated nursing and auxiliary staff to help coordinate Telehealth visits with RUHS specialty care clinics, Orthopedics, and Optometry. This has significantly decreased the number of transportation runs to the medical center, increased safety, and has positively impacted cost savings. Over the last year, CHS completed more than 600 Telemedicine visits. Specialty clinics include Dermatology, Orthopedics, Neurology, Rheumatology, Pulmonology, ENT, Cardiology, Podiatry, Hepatology, and Infectious Disease. In 2021, on-site Orthopedics and Optometry programs each saw more than 200 inmates. Lactation Program: In accordance with AB-2705, CHS was on the forefront of implementing a lactation program. CHS recognizes the importance of breastmilk for babies in giving them a healthy start. When a breastfeeding mom is incarcerated, CHS works to support the mom and the baby’s caregiver in their efforts to maintain the breastmilk supply. We have successfully provided services to incarcerated mothers who have meet the criteria for the program. Continuing Care After Release: CHS has been working with multiple Riverside County partners including DPSS and Whole Person Care to pioneer a comprehensive Medi-Cal enrollment process available to all inmates while in custody. The project included telephone access for incarcerated patients so they can communicate directly with DPSS eligibility workers. This was achieved without adding any personnel or other costs. Opiate Overdose Response Efforts: Drug overdose has been a significant healthcare issue for correctional patients for many years, however, in the last couple years,

FOURTH EDITION

the risk of Fentanyl overdoses has increased. Through state grants, CHS obtained Narcan and extensive education for staff. In addition to taking preventive measures to minimize the impact of Fentanyl in our jails, the medical team has received training in opiate overdose response. Over the past 18 months, staff has provided Narcan to more than 75 patients who were able to fully recover from a Fentanyl overdose. Through collaborative training and responsive efforts with the Sherriff’s team, multiple patients have been found-down, apneic, and pulseless but have been aggressively resuscitated and survived to discharge without neurologic sequelae. Vaccine Information: CHS continues to meet the challenges of COVID-19 with high-risk congregate living environment and high-risk underserved patient population through robust prevention, testing and treatment. In total, 2,331 COVID-19 vaccines have been administered within the adult facilities since January 2021. The CHS vaccination program has protected more than 1,658 individuals. Our department continues to work with RUHS pharmacy to offer the vaccine to all patients and staff members daily. As of today, 1,164 patients are vaccinated within our facilities. The successful program has maintained a positivity rate below 1%.

RUHS INNOVATIONS

Often, individuals in custody have neglected their own being. Illnesses that can be prevented or minimized and communicable diseases (e.g. tuberculosis, sexually transmitted diseases, etc.) may only be identified when an individual is in custody. The health of a jail population is often a reflection of the health of the high-risk populations in the community. Therefore, treating disease in jail can reduce the public health burden of disease in the community. Our physicians and nurses dedicate themselves to the care of those often held in low esteem, but they find reward in the impact they can make on lives who often have the least ability to reward or repay them. CHS is a calling with great personal and professional rewards, and we welcome new members to our team who have a desire to make an impact on the world around them. REFERENCES: Mesisca M, Minahan T, Carl B, Fillman T, Randall MM. Minimizing the Impact of COVID-19 in a County Jail Environment to Protect a Vulnerable Population. J Correct Health Care. 2022 Apr;28(2):80-83. doi: 10.1089/ jchc.20.12.0110. Epub 2022 Feb 21. PMID: 35196143.

EXPANDING BEHAVIORAL HEALTH CARE DURING THE PANDEMIC CONTRIBUTORS: MARCUS CANNON AND RHYAN MILLER

In the face of the pandemic, Riverside University Health System’s (RUHS) Behavioral Health rose to the occasion, meeting the ever-changing needs of the community — even in the face of uncertain times.

•Set up a 24/7 Healthcare Worker Support Line andVirtual capability for RUHS employees and community hospitals, frontline workers and emergency responders. This has been actively running since April 2020.

While Behavioral Health (BH) has always been an important part of the health system, COVID-19 created situations that were new, challenging, and always evolving. The team was faced with a variety of mental health needs, starting with greeting the first Wuhan arrivals at March Air Force Base, and going on to providing 24/7 support for the healthcare workers themselves, who were facing mental and emotional strain.

•Deployed management personnel to Join the Emergency Operations Center (EOC) at the request of the EOC and Public Health.

The proactive services that Behavioral Health staff provided were — and continue to be — critical to our patients and frontline staff across the Medical Center, Community Health Centers, and Public Health (PH). Here are some of the achievements that the Behavioral Health Team accomplished within the last two years: •Deployed BH teams to support the Wuhan arrivals on March Air Force Base with PH Teams. •Set up a 24-Hour hotline for community COVID questions (the BH Nurse Advice Line) to assist in original surge. This line was staffed by BH staff 24/7 until PH contracted the service out to 211. We then assisted 211 in altering their decision tree and added BH direct support in.

•Deployed clinical staff to assist in the SOS Teams support of Nursing Homes and inpatient community clinics. •Deployed support and other staff per request of EOC for other projects for surge activities. •BH Project Uplift: Deployed BH staff to Medical Center, Psychiatric Hospital, and all Community Health Centers to support staff due to surge and compassion fatigue associated with patient care. •BH Project Uplift, Tea Time: Set up clinical grounding, grief support, and mindfulness groups by Zoom for the ICU, Critical Care, Nursing, and Respiratory Teams. •BH Project Uplift: Focus 2, Loss and Grief: Set up onsite support to Medical Center starting Monday, January 4 for nurses and Family members that have loved ones hospitalized and end of life needs. BH will also have clinical therapists calling families who need grief and trauma counseling. •Built and licensed a 38-bed Mental Health Rehabilita-

FOURTH EDITION

tion Center (MHRC) at Riverside BH Campus to assist in psychiatric hospital COVID surge and level of care decrease with support of Department of Health Care Services (DHCS).

•Cathedral Palms permanent supportive housing devolvement (funded by No Place Like Home) will provide RUHS – BH 68 beds for homeless and elderly consumers in January.

•Set up and licensed a 20-bed COVID Person Under Investigation (PUI) Unit for the patients in Emergency Treatment Services (ETS)/Inpatient Treatment Facility (ITF) with the ability to surge to 40 beds as needed.

•Mental Health Rehabilitation Center (MHRC) added a new unit with 21 beds, making the total beds now at 59.

•Deployed the “Take My Hand App” months early. The 24/7 peer-driven mobile application is open to all hospital workers and community members for support during crisis. •Accelerated opening of Roy’s Desert Springs 92-bed Augmented Board and Care facility to enable the movement of patients needed to step down from locked Institute for Mental Disease facilities (IMDs). It opened months early with the help of Department of Health Care Services (DHCS) in August of 2020, and we have placed 66 of the 92 beds. •Increased BH Mobile Crisis Teams hours and staffing under emergency need so local Riverside Hospitals and RUHS – Medical Center could quickly respond to 5150 calls and transfers of patients from hospitals to ETSs, or break hold and connect patients to crisis walk-in centers and other appropriate placement to decrease demand on hospitals during surge. •For Desert hospitals with largest surge of concentrated 5150 calls, daily census set up telehealth to decrease response time and move patients to appropriate step-down placements outside hospitals or directly to ETS or private insurance provider. •Deployed BH HHOPE teams to support Project RoomKey. BH also supports these teams with clinical supervision of therapist interns, substance use disorders, and connection to permanent housing. •Opened a 16-bed Adult Mental Health Residential Treatment Facility (ART) in Indio in January 2020 to assist in IMD and hospital step downs.

RUHS INNOVATIONS

•Opened Arlington Recovery Community (ARC) SUD Residential which includes 48 Intensive Residential beds and 6 inpatient detox beds. •Behavioral Health opened a Sobering Center with 15 beds in Riverside. •RUHS – BH Substance Abuse Prevention and Treatment (SAPT): Opened new Substance Use Disorders (SUD) Outpatient Clinic at Palm Springs Community Health Center. •SAPT Contractors -Opened new 12-bed SUD Residential for co-occurring consumers in Banning. -Recovery Residences (Sober Living) added more than 50 beds across the county. -Assorted SUD Contractors: Brought on more than 40 residential beds spread out across new and old providers. •Adding 13 more grant-funded Mobile Crisis Management Teams across the county (with four staff on each team). •Community Behavioral Health Assessment Team (CBAT) added 11 teams of Crisis Ride Along Therapists with law enforcement. •RUHS – BH Restorative Transformation Center (MHRC) scheduled to open July 2022. Thank you to our Behavioral Health Team for your tireless efforts. We look forward to your future accomplishments.

MEDICATION-ASSISTED TREATMENT (MAT): LINKING SUBSTANCE ABUSE PATIENTS WITH BETTER CARE BY LISA MACKIE

The RUHS Emergency Department (ED) sees approximately 100,000 patients per year and serves the fourth largest county in the state of California. Due to these high volumes of patients, the ED is an optimal setting for screening and intervention for opioid use disorder, and there is also potential for staff to motivate patients to make a change. Through a grant, the ED Bridge/Medication Assistant Treatment (MAT) Team has expanded the Substance Use Disorder Navigator roles to build an inter-system relationship within Riverside County and the Inland Empire. Funding has allowed for the addition of counselors and navigators which has drastically improved overall access to resources and improved treatment of substance abuse disorders and linkage to care. The opportunity has also helped enhance available resources for system partners and the community we serve by further developing our ED-based addiction medicine profile and behavioral health services.

In collaboration with Behavioral Health, the ED continues to educate against stigma around mental health and addiction medicine to improve patient outcomes and services provided. By adding the MAT component to regular screening, brief intervention, and referral to treatment protocols, patients can cease illicit opioid use more immediately, avoiding potential health consequences that often occur during the delay between referral and treatment. In addition, the ED has expanded efforts so they can provide services to help the patient seeking treatment live a productive, fulfilling life. These efforts, in collaboration with X-waivered physicians (who can write precriptions for buprenorphine), ED nurses, the ER nurse educator, and our Behavioral Emergency Response Team (BERT), work to assess and recognize patients in need of referrals and/or treatment programs. The ED at RUHS believes that these efforts can significantly decrease morbidity and mortality rates within the community during this ongoing opioid epidemic.

FOURTH EDITION

BLACK INFANT HEALTH PROGRAM HELPS WOMEN HAVE HEALTHIER BABIES BY CURLEY PALMER

According to the March of Dimes, in California, Black babies have the highest preterm birth rate of 12.6 per 1,000 births and an infant mortality rate of 8.3. That’s twice the rate of White babies. The Black Infant Health (BIH) Program is responding to this health disparity for Black babies and mothers in Riverside County. The RUHS – Public Health Black Infant Health (BIH) program offers culturally appropriate services that respect the participant’s values and beliefs. Within a culturally supportive environment, and honoring the unique history of Black women, BIH aims to help women have healthy babies. Participation in the BIH program is simple. Individuals must be a self-identified African American, 16 years and older, pregnant or have a baby who is less than 6 months old, and live in Riverside County. BIH provides mothers a free public health nurse and social worker as a support. In addition, the BIH program includes empowerment-focused group support services to improve the health and social conditions for Black women and their families. Activities draw from promising practices and are based on the findings of a 2010 comprehensive assessment of the BIH model. Women attend 10 prenatal and 10 postpartum group sessions designed to empower and support participants. Group sessions are led by culturally supportive staff who reflect the target population served and provide attendees with the opportunity to bond and support other pregnant women.

RUHS INNOVATIONS

Sessions cover a variety of topics including: Cultural heritage as a source of pride, healthy pregnancy, labor and delivery, nurturing ourselves and our babies, stress management, encouraging healthy relationships, and prenatal, postnatal and newborn care. Lastly, BIH provides client-centered life planning which is intended to further empower participants to make healthier lifestyle choices. Topics covered include: Referrals for identified services (e.g., medical, dental, mental, social), guidance on family planning, identification of strengths and problem-solving skills, and assistance with setting short and long-term goals. BIH also supports moms with case management services, particularly for participants who are unable to attend the group experience. BIH has been and continues to serve as a critical program for families in Riverside County, and it is because of partnerships such as those in place with RUHS – Medical Center, Comprehensive Perinatal Services Program clinics, and other community partners, that important strides continue and have a greater reach. To refer to the BIH program, please call (800) 794-4814 or email MCAHRivcoReferrals@ruhealth.org

CLOSING CARE GAPS WITH THE HEALTHY PATIENT OUTREACH PROGRAM (HPOP) BY DR. SHUNLING TSANG

Many times, we may need a little nudge to help us complete our preventive health care needs. Our Healthy Patient Outreach Program (HPOP) proactively reaches out to patients to engage them on the importance of completing preventive screenings. They help educate, provide appointment options, and review open orders to encourage patients to complete their care gaps. Our HPOP team started in August of 2020 with four team members, three of them with nursing backgrounds. Fabiola Falcon, our program coordinator, leads our HPOP team. HPOP outreach projects have included: •Cancer screening outreach for cervical, colorectal, and breast cancer •Well-child visits •Diabetes care, including retinal exams As part of our holistic approach, the HPOP team is trained to address all open care gaps. For example, if a team member is calling a patient specifically about diabetes-related care, our team can also assist patients by reminding them to complete tests that have been ordered by their provider or schedule a mammogram if it is due. Our HPOP team has made a significant impact on patient lives and on quality outcomes at our Community Health Centers (CHC) in several ways. Increases have been noted on care gaps closures where the HPOP has conducted targeted outreach. A recent example includes outreach for retinal exams where clinic managers noted that retinal schedules were consistently filled, helping to meet retinal exam productivity targets.

who are very busy, have expressed gratitude for the outreach calls to schedule their screenings and for having the opportunity to ask a variety of clinical questions. Our bilingual staff is available to serve our Spanish-speaking patients in their primary language. Patients have commented that they feel comfortable with the HPOP staff and appreciate the attentive and caring customer experience from our team. “I am very happy to work with the HPOP team. They are knowledgeable, customer-service oriented, and always very welcoming,” says Fabiola Falcon, HPOP program coordinator. “They are compassionate and care about the people they do outreach to, and in some cases advocate and go above and beyond to meet the patient’s needs. Last but not least, they have been working very hard to develop processes and good working relationships with the CHC’s staff.” Cancer Screening outreach efforts: Leveraging technology, more than 14,714 patients have been called for cancer screening care gaps. 5,297 patients have been reached, and 2,648 patients have requested a call back. HPOP Productivity from January through May 5, 2022: •1460 completed calls •1543 letters mailed •513 patient needs addressed

During the HPOP well-child visit outreach last summer, we saw an 9.6% increase in pediatric well-child visits as a result of the teams’ efforts. This year, the HPOP teams have been working to increase access to cervical cancer screening by finding opportunities in partnership with the CHCs. When the team is unable to reach a patient, they send a letter with a direct call back number. This has increased patient engagement and satisfaction. Patients, many

FOURTH EDITION

CAL AIM: ENHANCED CARE MANAGEMENT FOR PATIENTS WITH COMPLEX NEEDS BY JUDI NIGHTINGALE

For patients who receive care from multiple locations that sometimes provide overlapping services, figuring out medical appointments and getting answers to health questions can be an overwhelming experience that feels a lot like playing Connect the Dots. Communication between different departments and different medical offices is sometimes complex whether it’s due to different medical intake forms, difficulty accessing electronic medical records, or no process for sharing medication information. Patients with multiple diagnosis and care needs are often already stressed — physically, emotionally, or both — which makes this task an even heavier burden. Through the California Advancing and Innovating Medi-Cal (CalAIM) initiative, there’s an effort to relieve patients of having to connect the dots on their own: Enhanced Care Management (ECM). RUHS has 13 ECM teams in their 13 clinics includes: •Register Nurse Care Manager •Behavior Health Specialist Care Manager •Care Coordinator •Community Health Care Workers

RUHS INNOVATIONS

With ECM in place, the burden of getting the right medical care is relieved by a team of people who are equipped with the right resources. For example, for a person transitioning outside of incarceration, the first few months after release can present obstacles such as homelessness, no support system, or lack of money, time, or transportation. They also might not know how to access services that can help them successfully integrate back into their community such as insurance (Medi-Cal), substance use treatment, behavioral health care, physical health care, and affordable medications. An ECM team member would be able to guide someone navigate their healthcare journey, making it a less confusing and frustrating experience. Since offering their services in January of 2022, the ECM team has helped patients navigate their healthcare appointments and questions, making their experience more positive and increasing their chances of a healthier future.

PROVIDER SPOTLIGHT: AN INTERVIEW WITH DR. SIDDIQA NAWAZ Dr. Siddiqa Nawaz grew up in Riverside County and has now returned to the region, joining the RUHS team as a full-time physician at the Hemet Community Health Center. Dr. Nawaz joined RUHS in January of 2021 and will be moving her practice to the RUHS Main Campus Community Health Center in Moreno Valley in the future. Dr. Leung: Can you tell us a little about yourself? Dr. Nawaz: I grew up in Pakistan, and in 1999 my family decided to move to this area. I was 13 years old. I went to middle school in Hemet, completed high school there, and then went to UC Riverside. In 2009, I went to New York for medical school, residency, and to work. I returned to the area in 2019. I am married now, have two beautiful children (my daughter is 3 years old, and my son is 2 years old). My husband, also a physician, is here too. Somehow the stars connected, and I ended up with a job at RUHS, and in particularly in Hemet, the community where I grew up. I have been working here for the past year and a half. Dr. Leung: How did you decide to join RUHS? Dr. Nawaz: It is interesting because when I was starting my clinicals in 2011, I did have the opportunity to do my electives here and my residency here – but I did not want to wait so I made the decision to go to New York. When we were thinking of coming back, it was on my mind, but I did not know what to expect. I have personal ties here. I went to UC Riverside for my undergrad. UC Riverside now has a medical school, and RUHS is a teaching hospital for UCR. I wanted to work in a hospital or organization with a teaching background. That is very important to me as a physician. I want to keep connected with knowledge and have a sense of community and a sense of belonging. That was one of my major reasons. And also because it was a community hospital — that also interested me. I wanted to work with the underserved and underprivileged patients. If I go back to my background, that was one of the core reasons why I wanted to go into medicine. RUHS did offer me various areas of interest. And I wanted to work in an FQHC [Federally Qualified Health Center] setting.

hopes and dreams to come here, get a job, and for us to go to school here. As soon as we got to the US, though, he became severely ill. He previously had some medical conditions, but he did not know how serious his chronic conditions (like diabetes) were. He had congestive heart failure and diabetes that led to kidney failure. At that time, I did not really understand what was happening. He had a heart attack and bypass. This all happened at the end of 2000. I experienced life on both ends when we moved here. My dad’s older brother, who did the sponsorship for us, is a neurologist. He worked in Hemet as a neurologist at that time (Dr. Kyali). I have another uncle, my dad’s younger brother, who works in the same town as an internist. It was an interesting mix. I was very young, so I did not understand what was happening with my dad. He was able to get health insurance and see the doctors he needed to see because of the help from my uncle. They were facilitating this for him. He was getting very timely healthcare. There were difficulties for our family, as there was a language barrier and we were not doing well financially because my father was not working. I was inspired by what the doctors were able to do. But I also felt the frustration of everything my mom had to go through with three children. This is where County of Riverside holds a lot of meaning for me. Because in that time of need, the county helped us through financially, with health insurance, and all those different aspects. That as a big part of my motivation to come back. I see patients daily, and I get where they are coming from. I get not having insurance. I like being able to help patients get Medi-Cal. We now have language phones to connect with our Spanish speaking patients — we did not have this language capability when I first started going to appointments with my father in the early 2000s.

Dr. Leung: You mentioned that you wanted to work with an underserved community. Why did you feel that way?

I try to relieve the initial anxieties that a patient has when they come to the clinic. I like to know what their socioeconomic background is. To show them that I understand that it’s overwhelming when the doctor tells you that you need to go on a low-salt diet, restrict fluids, and check your weight on a daily basis. Providing good care is about helping patients learn to use CPAP machines. My father was on peritoneal dialysis for almost 3 years, and my mom did that for him. Her ability to learn how to do that for him reduced our costs.

Dr. Nawaz: When we moved to the US in 1999, my father — who had worked as a banker in Pakistan — had

When I talk to our patients, it is very easy for me to relate with them. We aren’t successful all the time. The non-

FOURTH EDITION

compliance remains. But I understand. Sometimes they do not have enough food stamps to buy groceries they need, but I’m still there for them. I let them know that I am there for them. I let them know why their medical conditions may be worsening, what some of the comorbid conditions can occur, and what further burdens they are going to have on them and their families. That is my mindset when I go to work every day.

to try to provide the level of care that we need to provide with the number of patients we see daily. Really helping them requires slowing down, listening, and taking the time to go through the WPHS.

Dr. Leung: That is very inspirational. You mentioned that at the beginning that part of your childhood you grew up in Pakistan. I was wondering how that may have informed your life view.

Dr. Nawaz: My patients inspire me daily. For me the pandemic did not change much. I was able to have a job, I was able to work. I did not have a family member become seriously ill due to COVID-19. I had access to vaccinations. But of the patients I see, a lot of them have lost their jobs. A lot of patients in Hemet work as a laborers or as housekeepers, and some of them may have lost all that income. But they come into the clinic and ask me how my day is going. When they ask those questions, they teach me perseverance. They are the ones going through all these hardships. But they make it to their appointments, and they are still trying to take care of themselves. In that way, my patients inspire me to keep going and to keep working.

Dr. Nawaz: Being considerate. Being respectful to elderly patients. Diversity was not really part of things when we grew up. It is a country in which everyone had the same religion and ethnicity. But coming here and learning that and being able to practice. The aspects that I would say I was able to bring from Pakistan are that I learned to be more considerate and resourceful. And now I appreciate the importance of having that access to primary care and the whole system, where you can call and make an appointment. There is organization with a front desk person, there is a doctor, there is a nurse. I did not grow up with any of that. Basically, in Pakistan, you go to the hospital when you are really sick. And I see that similarly with patients who come to my clinic. They come when they are really sick. For example, I have diagnosed lung cancer, breast cancer, colon cancer, advanced chronic obstructive pulmonary disease, congestive heart failure — these are the patients we see daily. So I can understand how they get to that point. Not having the luxury of time to make those appointments. In Pakistan, it is a similar setting. I value the role of a primary care doctor: How we can help prevent acute illness from developing into chronic conditions or manage chronic conditions to reduce hospitalizations. In Pakistan, that is not something I saw. But I think it is very important — working from the other end of it.

Dr. Leung: The pandemic has been difficult for individuals, families, and communities. Do you have any advice or words of encouragement to share?

However tired I am, I still have so much to be thankful for. My patients may not, but they are here with a smile on their faces. All the new innovations and programs that RUHS tries to bring are very meaningful. I think our support staff, our managers, our nurses — everyone is there with that same mission. Our clinics are patient-centered clinics. We do not turn anyone away. We take the time to make sure we are doing everything we can. This interview took place on May 20, 2022 between Dr. Geoffrey Leung and Dr. Siddiqa Nawaz

I think being resourceful, being mindful, being humble, and being appreciative of everything that we have here that we can then offer to our patients. And especially in our clinics, we have so much. Such as our ECM teams. When we have difficult patients, they spend time with them, update their charts and share all the resources we have in our community. Dr. Leung: Can you tell us how it has been since you joined RUHS? Dr. Nawaz: It is very rewarding. My day is very meaningful as a physician. I do think that the setting and our patient population give us the feeling that we are trying to make a difference in people’s lives. It is very rewarding from that end. I do feel satisfied that I am able to give back to the county that gave so much to us in a time of need. I am very satisfied that we have the organizational level of support that we need. We are given much more than what I initially anticipated or expected. However, I would say that all of it is needed

RUHS INNOVATIONS

RUHS Awards & Recognition BY LESLEY ANNE BELLOWS

Champion Award in Health April 28, 2022: RUHS was selected as the 2022 Champion Award in Health by the Inland Empire Hispanic Leadership Council (IEHLC). The organization promotes business, education, and public policy to advance the Latino Community in the region. RUHS was recognized for leadership and impact in the Latino Community.

and Efficiencies for Financial Abuse Investigations, Adobe Sign as a Workflow Solution in the Provision of In-Home Support Services (IHSS). Congratulations to everyone involved and thank you for your continued work promoting the betterment of county services and programs. Riverside County Medical Association Awards Riverside University Health System and RUHS Medical Staff congratulates Dr. Arnold Tabuenca and fellow awardees on their well-deserved recognition for Outstanding Contribution to the Medical Association & It’s Goals Awards. Dr. Tabuenca’s extraordinary service has shaped generations of healthcare professionals. His commitment to education and heart for the community is beyond compare.

Accreditation May 9, 2022: The Jurupa Valley Community Health Center received its full accreditation. The American College of Radiology (ACR) recognized all mammography, Medical and Surgical Center, Clinic and Medical Center modalities with no findings or deficiencies. Achievement Awards May 9, 2022: Arlington Recovery Community and Sobering Center received several achievement awards from the National Association of Counties (NACo). The following programs were recognized: Arlington Recovery Community & Sobering Center, Coffee Break Podcast with Riverside County Child Support Services, Human Resources Enterprise Data Portal, Riverside County Office on Aging’s Holistic Assessment, Resources, & Transitions for Seniors (HARTS), Caregivers Matter: Innovative Strategies to Increase Caregiver Enrollment, FAST: Improving Outcomes

FOURTH EDITION

Quality & Engagement Awards May 11, 2022: The California Maternal Quality Care Collaborative honored RUHS – Medical Center with three Quality and Engagement Awards for providing outstanding maternity care. Thank you to the Women’s Health and Labor & Delivery Team for providing exceptional care to our patients!

RUHS INNOVATIONS

MOLINA HEALTH SUPPORTS RUHS – SAFE CLINIC BY LESLEY ANNE BELLOWS A bra drive spearheaded by Molina Health collected more than 3,600 garments during an event at the RUHS – Medical Center on April 29, 2022. Garments were donated to the RUHS – SAFE Clinic, which provides crucial services for sexual assault and domestic violence victims. Individual donors dropped off items at bins placed at County offices, while Amazon contributed a van full of bras to support the effort. News of the event was shared across multiple teams throughout Riverside County, resulting in an inspiring amount of donations. When patients come in for an exam at the SAFE Clinic, sometimes they need to replace articles of clothing such as bras. On average, the clinic provides 350 forensic exams a year, so drive organizers set a goal of 500 bras to ensure that the need for bras was met. The response from RUHS employees, combined with the generous donation from Amazon, culminated in a tremendously successful event at the Medical Center. With the total amount collected, the clinic has enough bras for at least five years.

The crowd erupted in cheers when Abbie Totten, Plan President for Molina Healthcare of California, announced that 3,446 bras had been collected by that afternoon, with more on the way. The bra drive was attended by elected officials. Riverside County 2nd District Supervisor Karen Spiegel and Riverside County 5th District Supervisor Jeff Hewitt attended to assist and thank those who showed up to donate. Karina Meza-Vazquez, Victim Services Supervisor for the Riverside County District Attorney praised the partnerships within the county, saying, “I think it’s important for us to collaborate to support victims of sexual assault. I’m glad we could all come together and help victims of crime.” Volunteers from RUHS – Medical Center, RUHS Foundation and Molina Health were there to receive donations then sort and organize them by size. Thank you to everyone who donated. Your generous gift will play a vital role at RUHS – SAFE Clinic!

FOURTH EDITION

RUHS TEAMS UP WITH LIFESTREAM DURING BLOOD SHORTAGE BY LESLEY ANNE BELLOWS

Blood donations play a critical part in the day-to-day operations of a hospital. Donated blood can be lifesaving for those who need a blood transfusion due to serious medical conditions, injuries and surgeries. However, the amount of blood donations has plummeted during the pandemic due to government shut-downs, as well as concerns about hosting events in general. Many highschools and colleges who once held regular blood drives have switched to virtual classes and are no longer providing regular blood donations that many blood banks relied upon. The amount of blood donations has been so low that in January of 2022, the American Red Cross declared its first-ever blood crisis, which meant that hospitals would not be getting the amount of blood that they requested. Even worse, some hospitals would be receiving less than 25% of the amount that they’d asked for. Multiple blood banks throughout the region reported having less than a one-day supply on hand, making the levels so low that it’s classified as critical.

These efforts have resulted in record-breaking numbers of blood donations from the RUHS - Medical Center, and have also generated interest in holding additional blood drives throughout Riverside County. In January (which is National Blood Donor Month), the Riverside County Board of Supervisors marked the occasion by issuing a proclamation, thanking lab and blood bank members, for their dedication and tireless efforts in the midst of a nation-wide blood shortage.

To support the needs of our patients and the community, Riverside University Health System (RUHS) has been partnering with local blood bank, LifeStream to encourage blood donations, and to make it easy for staff to donate during their lunch break or after their shift ends. In addition to monthly blood drives, RUHS has been a vocal advocate for blood donations, including presentations to the Board of Supervisors, the Greater Riverside Chamber of Commerce, and engaging with local media.

Please consider signing up to donate at RUHS Medical Center’s blood drive, which takes place the first Wednesday of the month in the Magnolia Rooms at the Education Building. You can also help by spreading the word about the blood drives within your circle of friends and family.

RUHS INNOVATIONS

For more information on who can donate or to make an appointment, call 800-879-4484 or visit www.lstream.org/RUHS

EXPRESS CARE

AT RUHS COMMUNITY HEALTH CENTERS (CHC) Express Care can treat many common non-emergency illnesses and injuries.

SERVICES INCLUDE • Cold and ﬂu • Respiratory infections • Sinus, ear, nose, and urinary tract infections • Prescriptions • Vaccinations • Rashes, bites and burns • Preventative Screenings • Women’s Health Exams • Laboratory Services • Radiology Services: X-Ray and more • Fractures, sprains and splinting • Cuts, wounds, and laceration repair

LOCATIONS MAIN CAMPUS - CHC

26600 Cactus Ave Moreno Valley, CA 92555

CORONA - CHC

2813 S. Main Street Corona, CA 92882

OPEN DAILY

Walk-in or Call 1.800.720.9553

Hablamos Español TTY: 7110

Monday - Friday: Saturday - Sunday:

11:00am - 8:00pm 8:00am - 5:00pm

AFFORDABLE OPTIONS

RUHS provides low-cost options. If you have insurance, call in advance for rates. If you do not have insurance, please call RUHS specialists who can help. For emergencies such as stroke or chest pain, call 911 or visit RUHS’s Emergency Department right away.

SECOND EDITION

RIVERSIDE UNIVERSITY HEALTH SYSTEM - MEDICAL CENTER is proud to oﬀer Molecular Breast Imaging (MBI)

BETTER DETECTION + LESS COMPRESSION For The Whole Health Of You RUHS Medical Center is now offering screenings using an Molecular breast imaging (MBI) camera, which offers new ways to “look” at the breast in high risk patients, especially such as those with dense breast tissue. MBI is an additional test used with mammography to improve detection of cancer within the breasts. When a breast is dense, a cancer sometimes can be hidden by the surrounding normal breast tissue. MBI is not affected by dense breast tissue and can reveal breast cancers in women with dense breast tissue that mammography cannot.

951-486-4100

Radiology Scheduling Line Ruhealth.org | 951-486-4000 RUHS INNOVATIONS

*Cash pay option is available for insured patients. Please call for more information. 29

INNOVATIONS SERIES

Webinar

Riverside University Health System Innovations Webinar Series RUHS Innovations webinar series is resuming with new topics and tips that will allow you to make the most of these trying times. View and share our previous webinars at https://bit.ly/innovationswebinars

Upcoming Presentations All webinars are schedule to occur 12:15 pm - 12:45 pm

July 20th August 17th September 21st October 19th

Join the Webinar To receive an invite, please email us at webinar@ruhealth.org

Join our Microsoft Teams Webinar If you are interested in attending, please register by emailing us at webinar@ruhealth.org.

INNOVATIONS RIVERSIDE UNIVERSITY HEALTH SYSTEM

Dr. Edward Bacho EDITOR-IN-CHIEF Nicole Orr PRODUCTION MANAGER Ester Parada Bonilla DESIGN DIRECTOR Lesley Bellows Emily Hwang COPY EDITOR AND WRITER Cameron Cramer PHOTOGRAPHY

ARTICLE CONTRIBUTORS:

INNOVATIONS WORKGROUP:

Marcus Cannon Jessica Cuevas Terry Fillman Wendy Hetherington Andrew Jimenez Dr. Ronald Johnson Dianne Leibrandt Dr. Geoffrey Leung Lisa Mackie Dr. Michael Mesisca Rhyan Miller Dr. Thomas Minahan Judi Nightingale Curley Palmer Sheena Patel Lenore Gallucci Stevenson Dr. Shunling Tsang Dr. Chad Vercio

Dr.Edward Bacho Dr. Matthew Chang Dr. Raul Coimbra Dr. Parastou Farhadian Dr. Frank Flowers Jr. Emily Hwang Dr. Ronald Johnson Dr. Mahbuba Khan Dr. Vikram Kumar Dr. Geoffrey Leung Dr. Michael Mesisca Nicole Orr Dr. Adriana Rosato Dr. Shunling Tsang

RUHS MARKETING 26520 Cactus Avenue Moreno Valley, CA 92555 marketing@ruhealth.org ruhealth.org

RUHS INNOVATIONS

Riverside University Health System - Medical Center 26520 Cactus Avenue Moreno Valley, CA 92555 ruhealth.org