Week 49: Leveling the Playing Field
High quality health care should be accessible to everyone. As the leading academic health center in the region and its largest department, we have a responsibility to ensure that we have leaders in promoting and actualizing health equity. Last week, I had the opportunity to meet with the Venice Family Clinic’s executive leadership during a visit to the Simms/Mann Health & Wellness Center. I enjoyed receiving a tour and learning about the comprehensive services offered at Sims Mann, which provides care to a majority underserved patient population. I also enjoyed seeing our residents in action as Simms Mann serves as one of our clinical training sites. I appreciated the opportunity to sit down with VFC leadership to discuss next steps toward deepening the DoM's partnership to strategically enhance primary and specialty care capacity at VFC. As a department, we are committed to strengthening our partnerships with FQHCs and broadening our reach into communities in need. I am hopeful that we will make progress and look forward to sharing more information as we build our path forward.
Last week, I learned that pulmonary, critical care medicine fellow Jane Fazio, MD, and DoM DGSOM faculty at Olive View-UCLA Medical Center, Nader Kamangar, MD spoke with Public Health Watch about the increasing presence of silicosis among countertop cutters and stone fabricators in the northeast San Fernando Valley, who are majority Hispanic, Spanish-speaking, and on restricted Medicaid, a Medi-Cal program available to undocumented immigrants in California. Silicosis is an incurable, progressive lung disease caused by the inhalation of crystalline silica particles which travel to the lungs and cause scarring which results in affected individuals slowly suffocating. While Drs. Fazio and Kamangar are providing care to this patient population, they are also advocating to improve case reporting, prevention interventions and the development of treatment for silicosis to protect the lives of stone cutters and fabricators.
Ancient Lung Disease Strikes Countertop Cutters in Southern California - Public Health Watch
LOS ANGELES - The men are haggard, starved of breath and tethered to oxygen tanks. Neither will live to an old age; without lung transplants, both may die within a year. Juan Gonzalez Morin, 36, and Gustavo Reyes Gonzalez, 32, made a living cutting and grinding engineered-stone countertops, the...
In October 2022, Dr. Fazio presented a limited case series in Chest, providing an overview of ten cases of silicosis among this patient population. Since then, she has identified 50 cases and will be working towards reporting on these cases. She aims to lead a qualitative study to gain a better understanding of exposure history and lead cohort studies to understand disease trajectory, and to compare this group's results to previous cases of silicosis.
In April 2022, I was pleased to share that the UCLA TAVR team, led by Ali Nsair, MD, director of the Heart Transplantation and Mechanical Circulatory Support Program at UCLA, had successfully completed the first transcatheter aortic valve replacement (TAVR) on a patient referred over from the VA Greater Los Angeles to UCLA. Eight months later, I am pleased to share that the TAVR team has performed 9 TAVR’s for VA GLA patients. Thanks to the leadership efforts of Dr. Nsair, VA GLA, UCLA Health, the DoM, the nurse practitioners and nurses, this program is making an incredible impact in the lives of our veterans.
Most recently, Jesse Currier, MD, the director of cardiac catheterization laboratory and interventional cardiology, received this note from a patient sharing a message of gratitude after successfully undergoing a TAVR.
"December 5th, 2022
Dr. Currier,
A very sincere thank you to you, NP Fang and your team for guiding me through the pacemaker procedure and facilitating my transfer to UCLA. Dr. Aksoy, NP Gulton and especially NP Hutchting guided me through the TAVR procedure successfully.
Together you've given me a new chapter in my life and I will be very grateful for that for the rest of my life.
Merry Christmans, Happy New Year."
Our professional societies play an important role in ensuring that entire specialties remain focused on ensuring that all our patients receive care that is consistently of the highest quality. Therefore, it is gratifying to see our faculty assume leadership roles in these endeavors. As such, I am pleased to congratulate Boback Ziaeian, MD, PhD for being appointed the chair-elect of the American College of Cardiology/American Heart Association (ACC/AHA) Joint Committee On Performance Measures.
“I’ve been fortunate to serve as a member of the ACC/AHA Joint Committee for Performance Measures. As chair-elect, I will work with committee members on prioritizing and improving the current guideline processes for translating ACC/AHA Clinical Guidelines into implementable performance measures for healthcare systems working to improve the quality of cardiovascular care in the inpatient and outpatient setting,”
states Ziaeian.
He shares that for each ACC/AHA Clinical Guideline, a performance measure subcommittee is formed to prioritize evidence-based recommendations into structured measures. These measures are then published nationally and provided to the National Quality Forum and may be endorsed by payers such as the Center for Medicare and Medicaid as measures of healthcare quality.
“I look forward to the challenge over the next two-years and thrilled to serve and represent the UCLA Department of Medicine and Division of Cardiology,”
adds Ziaeian.
Also on the playing field, I am pleased to share that the American College of Cardiology (ACC) appointed Jeff Hsu, MD, PhD to serve as a member of the Sports and Exercise Leadership Council. In his new role, Dr Hsu will join other sports cardiology experts and thought leaders from around the country to develop educational training and programming for trainees and health care professionals interested in sports cardiology. The field of sports cardiology is relatively new, and this leadership council has been key to developing a curriculum for trainees who aspire to become sports cardiologists. Dr. Hsu has been actively involved in the ACC since 2018, with leadership roles that include serving as a case presenter and a faculty panelist who discusses challenging sports cardiology cases with other experts at their annual conference. For the past two years, he has also served on the planning committee for the ACC Care of the Athletic Heart Conference. He also serves on the ACC.org editorial team helping to publish educational content related to sports cardiology.
“Appointment to the Sports and Exercise Leadership Council is an opportunity to contribute to our patient community at the national level. I’ve worked hard to develop the sports cardiology program at UCLA and I look forward to helping patients and the sports cardiologists around the world learn how to best care for this patient population,”
states Hsu.
As I reflect on the scale and impact of our department in our college, health system, community, and country we are at a point in our history where we should explore and define strategies that will define our missions over the next decade. I am excited that a formal department-wide strategic planning process will begin in earnest in early 2023. The purpose of this important initiative is to define the DoM’s shared vision and values; to establish a strategic direction and priorities for our future across each mission area; and to create a clear plan to achieve and measure the goals we establish.
The planning process is designed to address four questions:
- Where is the DoM today?
- Where should the DoM be in the future?
- How should the DoM get there?
- Is the DoM getting there?
The process will occur in four phases over approximately nine months. Each phase includes planned activities to address each question, to ultimately inform a bold strategic roadmap that clearly defines a vision and strategic direction for the DoM.
We look forward to engaging the DoM community in this important effort through focus group, town hall, survey, and design team participation throughout 2023.
Dale
P.S.
I am sharing these pictures for Jeff Hsu.
This weekend, I got a shout out at the Bruins basketball game. I did not drop the ball.
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