Highland Hospital, and its heavily-used outpatient clinics, are expanding facilities and services, and the first new building opens this week.

Its Green and LEED-certified, open and airy, color-coordinated and  attractive.

Dubbed the Highland Care Pavilion, the new building will house many of the key clinical services the county provides to medically indigent and more moderate income residents.  This is where a large number of Oaklanders will receive medical care and support in the future.

With a second building already under construction, and plans to replace the hospital itself in 2015, this is the beginning of a rebirth of Highland and the entire Alameda County Medical Center (ACMC).  In fact, the county has re-branded its medical services as “Alameda Health Services” (AHS), and put together a more modern website to reflect this.

On the website, the new goals of the county medical system are to “promote wellness and provide top-quality health care to a growing and diverse community” and “eliminating disparities and optimizing the health of a diverse East Bay.”

IMG_1816Overall, the Highland clinics will have more examining rooms for use by more doctors and nurses in an effort to significantly reduce the long waiting periods to be seen in all of its specialty clinics.  This includes a major expansion of the now over-subscribed Orthopedic clinic services.

July will see the opening of specialty clinics at the Eastmont Clinic, including an Ortho clinic, and an expansion of the clinical facilities there.  In early 2014, AHS will open a new clinic in Hayward which will provide most medical services.

Speaking about the growth in clinical services in the future, Stephen Kilgore, Director of Nursing for the HCP, said, “Services like Cardiology and GI, which are some of our big service lines, now that we have more space, we hope to have [these clinics] more consistently, maybe even up to every day, if there is a need.”

Jerri Randrup, the Director of Corporate Communications at AHS,  told Oakland Local that the new building will have more options for primary healthcare.  “This is a safety net hospital, and we provide that safety net to people who don’t otherwise have access to care.  So we’ll have a Same Day clinic as well as the ER.  It’s meant to be an alternative for people who would normally go to the ER, and we want to get the point across that you could be seen the same day.”

The Same Day Clinic will attempt to see people with non-emergency medical problems.  This clinic will also have a Fast Track area for simple problems like prescription renewals, skin-tests, and form-processing, geared towards getting people in-and-out faster. There is a blood draw and lab area area within the Same Day Clinic so patients will no longer have to go to a different part of Highland for these basic services.

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Same-day appointments are available for both new and regular Highland patients until the slots fill up. Because its a new service, Kilgore said they don’t have an estimate of when the appointments would fill up each day. If there continues to be a strong, unmet demand, AHS will consider expanding the Same Day Clinic to 7 days a week in the future, depending on if they can hire enough staff.

This service, however, is only for adults.

A new cafeteria is being finished below the lobby area. It will have an open grill, a gourmet pizza oven and an adjoining set of conference rooms for meetings and remote consultations. There is no opening date set yet for the new cafeteria.

Another bonus to the new building are the 175 patient parking spaces below the lobby and cafeteria. Highland volunteers will be greeting people at the old parking structure and redirecting them to the new parking area if they have appointments in the new building, reducing their walking distance and travel time, not to mention potential confusion. However, parking fees will remain the same.

AHS provided 297,889 outpatient visits in 2012.  They also performed over 5000 surgeries, and served over 2000 trama center patients.

Here is an interesting and favorable comparison of services at Highland Hospital with Kaiser and Alta-Bates [from March 2013].

Currently, many of the specialty clinics have appointment waiting periods of over 60 days.  Many health insurance plans require that wait times for appointments be less than 30 days. With more clinic space and the new Same Day Clinic, AHS expects to meet this requirement by early 2014.

Caring and healing for all

The Med Center has been reorganizing along the mantra of “patient-centered care.” The new mission statement says it succinctly: “caring and healing all.”

In a process going back more than a year, the project office has worked and re-worked the internal processes of every department at Highland Hospital, as well as the County’s satellite clinics, to achieve a fair similitude of that mantra.  This means the standard of care is going up, and many of the obstacles to receiving that care are being eliminated.

The county used the Lean and Keizen methods of process improvement, methods applied at corporations like Toyota and Dell. The goals were two-fold: reduce duplicate and wasteful processes, and meet patient’s needs quicker.

As part of its preparation for the Affordable Care Act [ObamaCare], AHS also recruited patients and interested family caregivers to form a “Patient and Family Advisory Council”  (PFAC).  This group has met monthly for over a year and helped set priorities for the Highland Medical Center make-over.

Lynnette Burris, a Highland patient for for several years and a current member of the Patient and Family Advisory Council, was impressed with the beauty of the the new building.  “I like the artwork in the lobby area.  The embroidered artwork looks so vibrant.  The artwork [shows] devotion, dedication and great detail. To me, it’s an example of the new Highland.”

The Pharmacy Department was an early target of the Lean process, and showed lots of inertia. The Patient Council raised issues about the pharmacy early on, and asked for regular updates on changes.  The Patient Council also made several suggestions about improving the signage and the interminable, hours-long queue. Eventually the Lean workshops took hold, the staff reviewed the suggestions and experimented with work flow improvements, and positive results were garnered.

In the last few months, that long queue has shriveled from hours to 20-40 minutes, and users of the Highland Pharmacy are now being called by name over the PA.  This is a huge change from the old situation where people stayed in line for hours, uncertain when their prescription would be ready, and tempers occasionally flaring into fights.

Similar changes are coming to every clinic and department, especially as the two new buildings come into full service. The increased space means more examining rooms and more seating for patients, but also provides the facilities to hire more physicians. More rooms and doctors also means shortening time waiting for appointments and, hopefully, shorter waits for patients.

To that end, the Medical Center is making it an early priority to expand its Orthopedic services by hiring more Orthopedic specialists and opening Ortho clinics at its satellite facilities.  The aim is to serve more patients across the entire county and serve them with less delay.

Bill Manns, the COO of AHS, told the Patient Council in May that the Medical Center intended to become a center of excellence, providing patient-centered care and healing to county residents. “This is a sacred mission,” he explained.

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