April 2018: Yes, You Can Change Your Local Culture of Care


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Vol 1 Issue 2

Dear friends,

Just recently I had the privilege of sitting with a bold team of Upstreamists at the Inland Empire Health Plan as they defined the vision for their new population health strategy. Beyond goals for services provided or patient outcomes, they set their sights on something broader: building a culture of health.

That alone would have been a breakthrough in a healthcare industry that’s accustomed to constraining its work to the clinic or the operating room. But then, through a conversation that we’ve helped them cultivate, these Upstreamists added another word: equity. With that stroke of a pen, the health plan chose to assume responsibility for fostering “a culture of health and equity” in its community.

The role of culture in health is growing ever clearer these days, whether it’s the culture of a neighborhood, a nation, or a clinic. Organizations such as the Robert Wood Johnson Foundation, with its Culture of Health campaign, are encouraging this new mindset.

At HealthBegins, we’re working to stretch this paradigm shift further, to define the vision for all of us in health care as a thriving culture of health AND equity. This change permeates both our communities and our workplaces, where it shapes what we expect of medicine — and of ourselves.

Culture change sounds difficult, and there’s no doubt that it takes doing. But our highlights this month demonstrate that it’s more doable than we tend to imagine:

  • Our latest blog post recounts how one California clinic is changing its culture of care for at-risk patients — and making measurable impact — through a simple strategy called Community Health Detailing.
  • HealthBegins’ Sara Bader recently explained Upstream Quality Improvement at the Beyond Flexner Conference, a forum for the passionate medical students, educators, and residents who will build the future culture of medicine.
  • Finally, our latest webinar, a collaboration with Hollywood, Health & Society, revealed how medical professionals can help TV and film writers craft storylines that transform health norms.

Ultimately, culture is us. And together, we are making it new.



Rishi Manchanda

New from The Upstreamist, the HealthBegins Blog:

The Simple Intervention That’s Helping Solve Social Needs in One of America’s Most Diverse Counties

Pharmaceutical companies first used this technique to weave their products into doctors’ prescribing habits. Now social-medicine advocates are adapting it to improve upstream care. In one California clinic, this Community Health Detailing increased referrals to social services more than 15-fold in just four months.

A Health-Plan Executive Tears Down Walls to Unify Medical and Behavioral Care

Upstreamist in Action: Jennifer Sayles incentivizes clinics to build complex-care teams whose work is as integrated as patients’ needs are. Patients in the program are already seeing lower blood pressure, blood glucose, and depression.

How to Put a Number on the Value of Upstream Care

During our Feb. 27 webinar on financing medical-social partnership, participants had lots of questions about the value of CBOs’ services. HealthBegins Senior Fellow Victor Tabbush has answers.

Coming soon! Watch for an invite to our next webinar:

Community Health Detailing: A Simple Strategy for Powerful Practice Change

“Detailing” is a method of one-on-one outreach that can help frontline caregivers build knowledge and change everyday practice. The pharmaceutical industry perfected the approach to coach doctors on prescribing its products. Now we’ve adapted it to tap the power of community members and clinic staff to optimize health — and the results are powerful. In this webinar, learn how you can use Community Health Detailing to impact clinical outcomes for patients with health-related social needs.

Upcoming Events: Find HealthBegins Here

IHI Summit on Improving Patient Care
April 26-28 | San Diego, CA

A wide range of health care professionals in a variety of settings — primary care practices, community hospitals, and those working in specialty and ambulatory care centers — explore ways to improve ​care for populations and promote the health of patients.

TCA Clinician/Trustee/CEO Conference
April 26-28 | Lost Pines (Austin), TX

Senior-level executives, board trustees, and clinical leaders in the Texas Care Alliance gather to network, share best practices, and hear from nationally-recognized healthcare experts on the changing landscape of the industry.

USPHS Symposium
June 4-7 | Dallas, TX

Commissioned Officers of the U.S. Public Health Service meet for training and networking under the theme: “Ensuring Health for Generations to Come: Science Matters.”

Upstream News

Curated highlights of happenings affecting upstream care. Links are not endorsements.

Healthcare Providers Do More to Fight Hunger, But Efforts Could Be Hindered By Funding Cuts
Modern Healthcare

Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis
The New York Times

Climate Change Adversely Affecting Virginians’ Health, Study Says
The Washington Post

Work Requirements: SNAP Data Show Medicaid Losses Could Be Much Faster and Deeper Than Projected
Health Affairs Blog

#MeToo Has Had Little Impact on Medical World
Associated Press

In a Puerto Rican Mountain Town, Hope Ebbs as the Hardship Continues
National Public Radio

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