The Expected Practice: Transforming Clinical Care in the Safety Net

About the Program

Category: Health (Best in Category)

Year: 2018

As the second largest municipal health system in the nation, the Los Angeles County Department of Health Services (LADHS) has a mission to ensure access to high-quality, patient-centered, cost-effective health care. Like many other bureaucratic systems, legal, infrastructural and economic barriers often get in the way. A novel clinician-and health care organization-informed approach to overcome these barriers was implemented culminating in the LADHS Expected Practices (EP). The EP is a standard approach developed by consensus by specialty primary care workgroups. The EP is guided by 1) real-life practice conditions at our facilities, 2) available clinical evidence, and 3) the principle that we must provide equitable care for the entire population that LADHS responsible for, not just those that appear in front of us. LADHS now has 190 EPs created spanning topics such as cancer screening, safe use of opioids, and obesity prevention. These high impact documents are downloaded over 3000 times per month and are utilized by approximately 50% of the 3000 primary care providers in our system. The approach taken has led to new medications being added to our formulary, changes to the electronic health record, and reallocation of resources bringing us closer to fulfilling our mission.