Becker's Clinical Quality & Infection Control

11 QUALITY IMPROVEMENT & MEASUREMENT Among the first priorities is developing two shelled floors at Palomar Medical Center Escondido to expand cancer, cardiovascular and other specialty services. UC San Diego Health's Moores Cancer Center, an NCI-designated comprehensive cancer center, will partner with Palomar Health's oncology teams to expand cancer care, including clinical trials. e organizations have already hired medical oncologists as part of the effort. Cardiovascular and cardiothoracic surgery services are also expected to expand early, with additional specialty programs planned aerward. "Building that clinical program is going to be hugely important for the district to be stable," Ms. Maysent said. "Financially, it's about going through every lever we have and trying to manage the P&L — strategic pricing, revenue cycle, supply contracts, procurement, and things like that. What other opportunities do we have to drive more efficiency into the system? It's really bringing us together to provide those synergies, which we think will help them sustain the impacts of HR1 and other challenges." A model for California? Beyond operational efficiencies, Ms. Maysent believes patients will ultimately judge the partnership by one measure: whether they can access specialty care more quickly and closer to home. "I think one of the biggest things you hear from patients is, 'I have a GI problem, but I can't get into my GI doctor for four months,'" she said. As an academic medical center, UC San Diego Health has access to a steady pipeline of residents, fellows and subspecialists. e JPA allows those physicians to practice in North San Diego County, reducing travel for patients while increasing appointment availability. UC San Diego Health is applying a different approach using a similar structure in California's Imperial Valley. is partnership is a separate deal built on the same premise: a struggling public district hospital, an academic system with clinical infrastructure to offer and a legal structure designed to keep both sides intact rather than absorb one into the other. Ms. Maysent said the shi shows up in her own job description. Five years ago, stabilizing other health systems was not part of the CEO role at an academic medical center. Now, she said, it is central to keeping the whole system running while also recognizing that patients are living longer with more complex health conditions and caring for them in newly built hospitals is prohibitively expensive in California. "Finding ways to stabilize the community health systems was not in our job description five years ago," she said. "Now I think it's essential." Ms. Maysent expects academic health systems will continue pursuing acquisitions and partnerships with financially challenged community hospitals as industry pressures intensify. "Acquisitions are going to continue," she said. "I think it's going to get harder because of all the challenges in our industry to keep doing it, although I think it's to the benefit of the communities where it happens that healthcare is sustained for them in a meaningful way." n CHOP's $50M bet: Make connection the next vital sign in pediatrics By Paige Twenter C hildren's Hospital of Philadelphia is betting the bond between a parent and child can be observed as reliably as blood pressure and taught to tens of thousands of clinicians nationwide. The bet has a new home. On July 22, CHOP announced the David M. Einhorn Institute for Early Relational Health with a $50 million gift from Einhorn Collaborative, naming Dani Dumitriu, MD, PhD, its inaugural director. Early relational health, or the quality of a young child's earliest bonds, is one of the strongest predictors of lifelong resilience. The American Academy of Pediatrics urged pediatric primary care to promote it in a 2021 policy statement. But unlike the blood pressure check pediatricians added at age 3, there is no agreed-upon tool for the exam room. "There really isn't anything ready for implementation," Dr. Dumitriu told Becker's about the AAP's 2021 policy. The institute's early answer is a lens, not a score. Through a decadelong partnership with Reach Out and Read — a nonprofit in more than 6,500 clinics across all 50 states — Dr. Dumitriu's team built the "Lens of Emotional Connection," a roughly 45-minute online training that teaches clinicians to watch how a parent and child come together in a face- to-face moment. Dr. Dumitriu said the network reaches about 30,000 providers. Early results are promising. In the first pilot, published in June in JMIR Medical Education, clinicians' confidence in observing those interactions rose sharply, and 91% called the training valuable. But only 207 of 653 invited clinicians, or 31.7%, finished it, leading the authors to conclude that real scale will require building the training into Reach Out and Read's core curriculum as a requirement. Dr. Dumitriu frames the work as field-building. "When you think about biochemistry, you probably see it as one field," she said. "But 100 years ago, there was biology and there was chemistry; and there were bold, visionary scientists who said, 'We're going to bring those two fields together at one table.' That's where we're at with early relational health." Dr. Dumitriu will add the title of David M. Einhorn Endowed Chair in Early Relational Health on Jan. 1. n

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