Year 2. July 10. More Graduations and Promotions.

By sjmartinez • July 10, 2023

The department of medicine (DoM) hosts the greatest number of training programs within the DGSOM. Over the past weeks, I have updated you on graduates of our residency and fellowship programs. However, there are others for us to celebrate. This week, meet members of our administrative and support staff who completed the Ambulatory Lean Academy at UCLA Health, and graduates of our advanced subspecialty training and our National Clinicians Scholars Program.

The Ambulatory Lean Academy at UCLA Health is committed to increasing problem solving and leadership capacity across our ambulatory practices, continuously focusing on improving the patient experience and growing the abilities and talents of our staff. Each year, the Lean Academy invites administrative leaders in the ambulatory practices to participate in a 14-week course focused on teaching Lean tools, principles, methodologies and leadership skills that will improve health system processes. Participants work closely with coaches and ambulatory focused peers to develop solutions to a problem in the ambulatory setting or pilot a new process.

I am pleased to share that five participants in this year’s cohort of 11 were from the department of medicine. I applaud the following administrative leaders who completed the academy and express gratitude for their commitment to improving the patient experience at UCLA and introducing new methods and practices that will enhance our ability to deliver leading edge patient care. Each Lean Academy graduate provided a description of their project and their experience in the program.

Aisha Z. Polk

Aisha Z. Polk
Outpatient Pre-Op Clinic Coordinator
Patient Services Representative
Internal Medicine Suites

The title of my project was "Preoperative Clinic Scheduling & Workflow." My team and I developed a comprehensive workflow aimed at optimizing patient access to care, scheduling, minimizing wasted time, and fostering improved communication between different clinics. Our primary objective was to maximize the number of patients, residents could attend to during their longitudinal clinics, allowing them to apply their skills effectively.

The principles of Lean Academy allowed me to embrace the quote by Henry Ford: "Coming together is a beginning. Keeping together is progress. Working together is success." This encapsulates the essence of my journey. Through continuous improvement and the application of Kaizen, my project has yielded positive results, as evidenced by data.

I remain committed to advancing the project further, constantly generating new ideas to refine processes, and with the collective efforts of my dedicated team, I’m confident in the continued success of this project.

Delma Aleman

Delma Aleman
Project Manager
Health System Operations

My Lean Academy Project was focused on “Increasing Clinical Awareness of the Chaperone Program.” The Chaperone Program trains members of the UCLA Health team with special training that allows them to ensure patient and provider comfort, safety, privacy, security and dignity during sensitive exams or procedures.

During the Lean Academy, the team and I used the lean methods to find and implement solutions to standardize the Chaperone Program. The standardization of the program has increased and maintained awareness about this initiative among our providers and staff.

Throughout the Lean Academy I was able to gain a better understanding of lean methods and tools in order to find the root cause and avoid assumptions. I have increased appreciation for team member’s perspectives and the importance of providing staff recognition.

Marina Amis-Garcia

Marina Amis-Garcia
Practice Manager
UCLA Health Primary & Specialty Care, Montecito

My Lean Academy Project focused on “Uploading External Image Reports Within 72hrs.” I reported how many external imaging orders are placed on a monthly basis and the turnaround time for uploading finalized reports into Care Connect. I proposed that the providers include a “smart phrase” that they created in their notes to appear on the AVS when patients check out and for staff to highlight and inform the patients how to contact the office to provide appointment status for imaging tests that will be completed at external facilities.

We created this process to include not only physicians and support staff to advocate for the patient, but also for the patient to advocate for themselves to ensure their care is handled in a timely manner. The Lean Academy provided great tools for getting to the root of a problem and creating a solution!

Robert Navarette

Robert Navarrete
Project Manager
Health System Operations

My Lean Academy project consisted of creating a process for “Addressing Staff/Employee Burnout.” I fashioned my A3 Strategy by collaborating with six Managers that were able to send the Qualtrics Survey “Addressing Staff/Employee Burnout” to their staff. The survey collected responses which captured the current state of employee burnout, conducted a root cause analysis, broke down the expected outcomes/benefits, developed a plan for distribution, and consider open issues. I gained so much invaluable information on the importance of addressing employee burnout and the toll it takes on our staff and our organization.

In attending and completing the Ambulatory Lean Academy, I could truly connect to my project (as mentioned in my presentation) by following the 6Ps of Lean Leaders. By connecting, giving recognition, and having clear expectations for our employees, we can reshape our process in hopes of keeping our team motivated, decreasing staff turnover, and lastly providing excellent patient care.

Movies Tokadgian

Movses Tokadgian
Practice Admin Supervisor
Beverly Hills Primary and Specialty Care

Our A3 project was called the "Ambulatory Clinic User Guide for IUD Device Placements." The clinic workflow was created to outline the necessary steps in cadence for all stakeholders involved in the procedure process from beginning to end (management, faculty, clinical staff, admin staff). The guide helped support our Beverly Hills Primary Care Clinic on Wilshire in integrating a new women’s health procedure for our practice with compliance, structure, and efficiency. We hope to share and roll out the user guide with other primary care and internal medicine offices that would be potentially adding this service to their practices.

Lean Academy has taught us to consistently innovate the way we deliver healthcare as we grow as an organization by benchmarking best practices and increasing the access to patient care.

Celebrating our Advanced Subspecialty Trainee Graduates

Last week we celebrated graduates of our fellowship programs, and we continue our celebrations by highlighting the next steps of our trainees who participated in an advanced subspecialty program. Within the department of medicine, we currently have 15 advanced specialty training programs. I invite you to join me in celebrating the graduates from the following programs and learn what is their next step in their journey towards becoming leaders in medicine.

Vijaya Surampudi, MD, MS appointed Clinical Chief - Division of Clinical Nutrition

Join me in welcoming Dr. Vijaya Surampudi, who has been appointed as clinical chief of the division of clinical nutrition in the department of medicine and the David Geffen School of Medicine at UCLA. Dr. Surampudi is an associate professor of medicine at DGSOM and serves as a quality improvement officer for UCLA Health.

Since joining UCLA, she has assumed leadership positions that include assistant director of the UCLA Medical Weight Management Clinic and the co-creator of newly developed Adult Nutrition Support Services for Enteral, TPN Management, and Nutrition Oncology for UCLA. Under her leadership, UCLA Health became one of the few academic medical centers in the country to offer adult home nutrition support clinics. Please join me in congratulating Dr. Surampudi on her appointment! You may view the announcement HERE.

Roger Lo, MD, PhD Awarded 2023 Translational Award from the V Program

Congratulations to Dr. Roger Lo, who is the recipient of a translation grant from the V Programthat supports “bench to bedside” research, whose endpoint leads to planning or initiation of a clinical trial. This is the third instance in which Dr. Lo has been awarded a V grant with other V awards granted in 2009, when he was recognized as a V Scholar, and in 2019 when he achieved his first translational grant from the organization. Over the course of the next four years, Dr. Lo will use the $800,000 grant to support the project, “Blocking Genomic Instability to Prevent Acquired Resistance,” which he describes below:

"Today, oncologists have in their arsenal highly active and precise systemic therapies but often times cannot predict which patients would benefit the most. A major contributor to this knowledge gap is the cancer’s ability to resist therapies. Here, we will focus on malignant melanoma, an aggressive type of skin cancer, where two major precision-oncology therapies were first developed. One targets the so-called ‘MAPK cancer pathway’ that sustains the growth of many cancer types, not just melanoma. The other consists of immune checkpoint blockade (ICB) therapy, which unleashes the body’s cancer-killing immune cells and has been approved in >30 cancer types.

In patients with melanoma, >70% and >40% of patients respond initially to MAPK-targeted and ICB therapies, respectively. However, after initial responses, ~20-40% of patients experience relapse due to their melanomas developing resistance to therapies. In this study, we will dissect how melanomas evolve resistance so that we can prevent resistance. In response to therapies, melanoma and other cancers diversify their genetic makeup, creating new species, and this diversity increases their chance of survival or ‘fitness’ through Darwinian natural selection. We will identify ways in which melanomas diversify in response to these two pillars of modern-day cancer treatment in order to construct new therapies to prevent cancers from coming back. Preventing resistance will spare patients from the emotional and physical tolls of clinical relapses and surgical and radiation therapies to control resistant tumors. Ultimately, preventing resistance will improve the patients’ quality and quantity of life and reduce financial tolls."

DoM Grand Rounds is Back and In-Person!

After a three-year hiatus, the department of medicine was pleased to host the first in-person DoM Grand Rounds welcoming faculty, staff, and trainees to Tamkin Auditorium to hear speaker Eric Yang, MD, FACC, FASE, FAHA, associate clinical professor of medicine in the division of cardiology, discuss his predictions for the field of cardio-oncology in 2023.

Over 200 participants joined us in-person or via zoom to discuss the importance of recognizing and treating cardiovascular disease in the growing cancer population, learn the common cardiotoxicities in the cancer population, and review gaps in knowledge and the future of cardiotoxicity surveillance, diagnosis, and treatment. Dr. Yang also highlighted connections between cardiology and cancer, identified what drives disease process, and how society needs to improve our ability to provide equitable healthcare.

**Click to View Clearing the Growing Wilderness of Cardio-Oncology: Predictions for 2023.**

Please mark your calendars for every Thursday at noon and join us at Tamkin Auditorium for the new academic year of Grand Rounds. This week, Tzung Hsiai, MD, PhD will be leading DoM Grand Rounds. I encourage faculty and trainees based in Westwood to attend in person. See you there!

Dale

P.S.

My granddaughter and her parents are in town this week. Although we told our kids constantly to pick up their stuff left lying about the house, funny how grandchildren are exempt!