In Spring 2013, we are on the precipice of dramatic, disruptive change in the health field that offers an unprecedented opportunity and challenge to transform health care and population health. We know that traditional public health approaches along with more and better health care are not enough to improve health outcomes, equity, and cost. We must also: - implement sustainable, fundamental "upstream" changes that address the root causes of disease and disability; and - transform the way we deliver health care to ensure access to quality, affordable health care for all. Enjoy this Bright Spot presentation from Pat Dennehy of Glide Health Services, which was presented at the 2013 Annual Leadership Conference, co-sponsored by the Center for Health Leadership (CHL) and the California Pacific Public Health Training Center (CALPACT) at UC Berkeley's School of Public Health. To learn more about this event, please visit: http://calpact.org/index.php/en/events/leadership-conference Learn more about CALPACT: http://calpact.org/ Learn more about the CHL: http://chl.berkeley.edu/

1. Welcome to Glide Health Services
• Glide Health Services (GHS) is a Nurse-Managed
Health Center established in 1997
• Federally-Qualified Health Center (FQHC)
• Located in Tenderloin district of San Francisco
where residents face many health disparities
• GHS serves approximately 3,000 clients annually
for a total of 18,193 encounters / year
• 62% of GHS clients are homeless
• Services are delivered by multidisciplinary staff

2. http://www.ucsf.edu/news/2012/02/11509/glide-health-services-director-receives-leadership-award

3. Primary Care Services
• Preventative Health Care: immunizations, health screenings
(PPDs, mammograms, HIV, prostate exams)
• Management of chronic conditions:
Diabetes, Asthma, Hepatitis C, Hypertension
• Chronic Pain Management
• Urgent Care
• Women’s Health Services
• Young Adults 18-29 years old

4. Behavioral Health Services
1. Psychiatric assessment and medication management
2. Individual therapy
3. Case management
4. Integrated substance abuse services
5. 90 Day Outpatient Substance Abuse Program
• Professional and peer co-facilitated recovery support groups
• Individual substance use counseling
• Psychoeducation classes
• Supportive medications available to prevent cravings for alcohol,
tobacco and other drugs

5. HIV Counseling & Testing Services
• Rapid, statpack HIV screening/antibody testing
• Rapid, Oraquick Hepatitis C screening/antibody testing
• Linkage to services
• Community outreach and harm reduction kits
• Condom distribution
• Syringe access services
& safe disposal (needle-exchange)
• Drug overdose prevention,
education, & training

6. Nursing Case Management
• Care Coordination and Transition Services
• Patient Education
• Coordination of Social Services, Community Resources, & Referrals
• Patient Advocacy

7. Wellness Activities
• Pharmacist consultation appointments and group education
• Chronic Disease management classes and services
• Diabetes Management & Prevention Group for persons with
behavioral health diagnoses (SF Empower- www.sfempower.org )
• Chronic Pain Support Group
• Smoking Cessation Group
• Immunization Clinics
• Population Health education classes
• Individual & Group Acupuncture
• Tai Chi, gentle movement classes, aerobics, staff meditation
• Restorative Yoga

8. Electronic Health Record (EHR)
1) Facilitates continuity of care across disciplines and providers
2) Electronic Health Record improves health data monitoring and integration
of data into overall plan of care
3) Increases capacity to evaluate
quality and patient care trends
4) Allows access to shared data bank
and Evidence-Based Practice

9. Clinical Teaching and Workforce Building
GHS is a clinical training/placement site for the following types of students:
• RN students from UCSF Masters Entry Program in Nursing (MEPN)
• NP students from UCSF
• CNS students from UCSF and other local universities
• Health Sciences Students from local universities
• MSW interns
• Psychology trainees
GHS also offers a unique Nurse Practitioner Residency Program

10. What is our inspiration?
• Information obtained from Health Matters SF website
reveals that residents living in the Tenderloin Area of
San Francisco experience health disparities at a higher
rate than other areas of the city
• We are passionate about wellness and our community

11. A patient survey in 1999, repeated in 2007 revealed:
1. 48% of clients reporting behavioral health issues
(depression, Post Traumatic Stress Disorder,
schizophrenia)
2. 51% reporting substance abuse issues
3. 30% reporting both 1. & 2.
These surveys also revealed that clients seeking health
services preferred to receive those services at Glide,
even as providers sought to refer them to the external
behavioral health care system.
Size of our Challenges

12. 1) Continuity of care across disciplines and providers
2) One-stop shopping increases likelihood that multiple health
problems, particularly behavioral health problems, will be
addressed
3) Electronic Health Record improves health data monitoring and
integration of behavioral health into overall plan of care
4) De-stigmatizes behavioral health and substance-related problems
Benefit to Clients

13. *GHS receives funding from HRSA, Bureau of Healthcare Professions, Division of Nursing
San Francisco
Department of
Public Health
GHS Partners

14. 6/26/13
Thank You
We are grateful to our collaborative partners, dedicated clinicians and staff,
and volunteers who are so generous with their time.
We would also like to thank Saint Francis Memorial Hospital (SFMH),
our largest community partner. They have provided our uninsured patients
with free medications and diagnostic services since the clinic opened in 1997.
Patricia Dennehy, DNP, RN, NP-C, FAAN
Glide Health Services Clinic Director
2012 James Irvine Foundation
Leadership Award Recipient