@NAHC
7D Workflow Mania By, Lillawa Willie E.H.R. Project Assistant
On July, 11th, over 50 employees from Medical, Central Registration, and Administration came together to map current clinic workflows at Seven Directions. Armed with butcher paper, tape and a stack of post-its, seven groups worked for 4 hours mapping over 30 different workflows. Not only was the day an exciting team-building and learning exercise for all involved; it also marked a major part of our preparation for Electronic Health Records implementation.
San Francisco’s Medical Department will be the next site to begin workflow mapping, and CWD is currently working to map current workflows as well. Be on the lookout for an opportunity to participate in this exciting exercise in quality improvement for our patients!
Sample Workflow: A Very Basic One! Patient Arrives Patient Checks In MA Rooms and Vitals Provider Exams Patient Leaves
In this Issue: As you all know, NAHC has completed its transition to an electronic Practice Management (PM) system. This means that the business side of our work (scheduling, registration, and billing) is now done using NextGen. The next phase of the project will change the way we do our clinical work – medical charting, labs, prescriptions. Electronic Health Records (EHR) will fuel many more changes than the Practice Management implementation did. One way we can prepare for these changes is to begin mapping our processes out as they are now. Workflow mapping allows us to step back and look at current processes to see where we can improve the patient experience, so that we can build these changes into the system.
HR Buzz: What is Ergonomics? Employee Contribution: Reflection on Joy Harjo New Faces @NAHC, Welcome! August Employee Anniversaries Dental Head Start Services Know your Building: Facts about 3124 Be Smart with Supplements Community Story Corner with Lee Leon Sage Gathering for GOTL | AIDS Walk SF SF Dental Updates | Flyers and Calendar
HR Buzz
Office Ergonomics
By: Michelle Shawnego, HR Generalist Questions on “Ergonomics”? Call Human Resources or email us at: HumanResources@NativeHealth.org
periods of use with computers and Video Display Terminals • Workstation Design: Overall set up of your entire work station and having a chair that doesn’t fit you correctly
What is Ergonomics? Ergonomics is extremely important for every employee in our organization. At Native American Health Center, we promote health and safety and want every employee to have an ergonomic friendly work environment!
Tips on Preventing Ergonomic Injuries! • Keep your hands and wrists in the most “neutral” position possible • Your keyboard should be slightly lower than normal desk height • Take lots of “Micro” breaks (lasting a few seconds or so) to stretch and relax • Use indirect lighting or a desk lamp and ensure your monitor is at eye level or below • Use a document holder if you transfer data and keep frequently used items close to you
The word “Ergonomics” derives from two Greek words: ergon, meaning “work” AND “nomos” meaning” laws, to create a word that means the science of work and a person’s relationship to that work. Ergonomics focuses on designing workstations, tools and work tasks for safety, efficiency and comfort. Effective ergonomic design reduces discomfort and injuries and increases job satisfaction and productivity. What are the Common Ergonomic Risk Factors? • Awkward body postures: maintaining an awkward, unsupported or fixed posture such as bending, reaching or twisting for prolonged periods • Excessive repetition: doing the same motions over and over again • Eyestrain: Frequently associated with the long
Understanding Ergonomics: for YOUR Health!
Employee Contribution
Reflection on Joy Harjo By: Alana Russaw, Evaluation Intern
KPFA Radio + Poetry Flash + the International Indian Treaty Council present: JOY HARJO “Crazy Brave: A Memoir” (published by W.W. Norton & Company) Hosted by Mark Anquoe Co-host, KPFA’s Bay Native Circle Thursday, July 12, 2012- 7:30pm St. Paul’s Church, 114 Montecito Ave., Oakland This event was very enlightening and made me want to learn even more about the Native population. Joy can be described as a Renaissance woman; an artist, musician, traveler, mother, daughter and one with Mother Nature. She made us all feel so welcome in a room full of strangers. It seemed as if I had known her forever, however this was our first encounter. I had fun seeing things through her eyes for those 2 hours and I could not leave without purchasing a book. Crazy Brave is the perfect title for the text because through her immense courage we can see how brave she is. On the other hand, some may call her crazy for making it through such a tumultuous background with no resentment. She carries herself with so much grace and poise you would swear she is royalty. Her Native American roots are her platform which allows her to be tremendously proud of her ancestors and her connection to Mother Earth. She is well respected in the Native community but spoke towards her African and European ancestry as well. She is a woman who tells things like they are, and has no gripes with “stepping on anyone’s toes” because she is speaking her truth. You can tell she is confident in herself and was placed on this Earth to teach us all the importance of self reflection, love and being proud of who you are (the good and the bad). She exudes a peace we should all strive for. I was tired after a long day of work that day, but I went home showered and decided to go to the event with an open mind and heart but a closed mouth. You learn so much more when you are quiet; it helps you pick up on things you would normally miss. I left the event feeling rejuvenated, recharged and excited to finish my fellowship with a newfound understanding of the people……my people.
New Faces @NAHC
Sarah Monje Director WIC Department 3124 International Blvd.
Angela Tattini Nurse Practitioner Registered Nurse HIV Case Manager SF Medical Dept
Jerusha Norman Billing Tech 1 Billing Department 3124 International Blvd.
Debra Houston Billing Tech 1 Billing Department 3124 International Blvd.
Welcome to NAHC!
Employee Anniversaries Thank you for your service
Name Bonita Janet Lee M. Rhonda Lucy Meuypoo Bertha Natalie A. John S. Yadira Dawn M. Meriah R. Tashina S. Kateri Jennifer Kehinde U. Paloma M. Amy M.
Department Start Date Years of Service Trinclisti Oakland Medical 8/15/83 29 years King CWD 8/12/96 16 years Leon Maintenance 8/1/00 12 years Ramirez Oakland Medical 8/7/00 12 years Wright SF Dental 8/13/03 9 years Saeparn Oakland Dental 8/16/04 8 years Diaz SF Dental 8/12/04 8 years Aguilera Admin 8/22/05 7 years Parke CWD 8/10/05 7 years Oseguera WIC 8/28/07 5 years Lulua-‐Claxton 7D Admin 8/13/07 5 years Gille Admin 8/11/08 4 years Boyer-‐Armstrong SF Dental 8/31/09 3 years Chiu CWD 8/5/09 3 years Luna Admin 8/23/10 2 years Apara School Based Medical 8/29/11 1 year Flores SF Youth Services 8/3/11 1 year Victorino Oakland Dental 8/3/11 1 year
Dental Head Start Services
By: Ana Noriega
The #1 health issue affecting children enrolled in Head Starts nationwide is ACCESS to oral health services. There is an increased risk of dental disease in underserved, low socio-economic populations as a result of shortage to dentists serving the medi-caid population and shortage of dentists serving ages 0-5. In a 2008 survey conducted by California Health reported 24% of all children in a California have never visited a dentist and 49% of all children in California have }NEVER visited a dentist by age 5. It has always been our goal, in the Dental Department, to see a child by their 1st birthday. In the Fall of 2011 a partnership was established between the EB Dental Department and The City Of Oakland’s Head Start and Early Head Start programs. The goal for this partnership was to increase the access for all children enrolled in the Head Start programs, ages 0-5. Through the use of portable dental equipment, which was transported to 26 Head Start Sites, children were able to receive dental exams, cleanings, fluoride treatments and oral health education, all while being in their own school. This created greater access, not only for the services being received, but also allowed comfort for the children who were in an environment in which they were familiar with. The access extended to the parents, who appreciated the convenience, of dropping their children off at school and going to work without loss of wages. Children who needed more extensive treatment were referred to the Pedo Department where they receive treatment from familiar faces, Dr. Ching and Dr. Ng. In the Spring of 2012, our services expanded through the partnership with The Unity Council’s Head Start program, where our services were requested and very welcomed by the children and the community. As a result of our partnerships and expansions, we were able to provide Oral Health services at 30 Head Start/Early Head Start schools and increased access to 561 children. Our goal for Fall of 2012 is to increase greater access by expanding the services being offered at Head Start sites, sealants and minor fillings.
Get to Know your Building: 3124 International Blvd By: Larry Aguilera and Junuen Galindo
L: In terms of the building on 3124 the care it truly needs involves community safety. This is not the best neighborhood; therefore we all need to be aware of who comes into the building. Jerrold is at the entrance of the building, to watch those who enter. Also, it’s important for the community to be aware and alert. They can do so by not letting people in after 5pm. If someone asks for a certain department then wanders around the building, that’s like a red flag. They can have another intention and that is what can cause damage to a department or worse, amongst our community. Also, when an employee goes J: What protects the building? What are the hours for each out to lunch or away from their desk they should lock their office door. building? The address 3124 International Boulevard is legendary to those known within the NAHC community. But what about the structure/make-up of the building? There is one person who knows what the walls could say “if these walls could talk”—Larry Aguilera. Larry is the facilities supervisor who repairs, understands, and cares for all aspects of the building. I had the opportunity to meet with him to discuss some classified information about the structure/make-up of the building with the address 3124 International Boulevard and the 7 directions building.
L: Both close at 5pm and the alarm is set between 5-6pm, depending on the cleaning status of the building. Once the alarm is set, it is armed all night and will not be turned off until 8 am. If anyone is in the building and tries to get out, the alarm will go off.
But safety and security extends beyond the clinic so here are a few of Larry’s tips once you step outside of the buildings or even in your everyday life:
1) If you are crossing the street walk side by side to someone, but with 3 feet of space in between. This will J: When were the buildings built and how much NAHC buy lessen the chances of getting robbed. 2) If you are walking to your car always have your keys them for? ready in your hand. Then immediately lock the doors as L: 3124 International building was constructed in 1929 and it soon as you get in. was purchased for $175,000. The 7 directions building is 79 3) Carry a whistle. There are free whistles available for employees in Larry’s office (#204) This can be better years younger and it cost $23 million to build. screaming when there is an emergency. J: What is unique about the Seven Directions building? L: The seven directions building is a green building, it has motion detectors, and it has A/C with the cooling on the We understand that NAHC is comprised of many sites, roof and 23 individual heat pumps. and buildings, all of which will be featured in future articles. J: What type of special care/features does the legendary building need?
Be Smart with Supplements Adapted from Diabetes Forecast By Laura McLively, RD Did you know that supplements are NOT regulated by the federal government the way medications are? That means it’s up to you to be aware of the benefits AND the risks of any supplements you are taking. Here are some reported side effects and drug interactions of five common supplements from a recent study from the Center for Complementary and Alternative Medicine. Supplement Saint-John's-wort Echinacea Garlic Asian ginseng Ginkgo
Warnings and Interactions Interacts with many medications, including antidepressants, birth control pills, digoxin, ciclosporine, warfarin, anti-seizure drugs, and HIV medications. May cause allergic reactions, such as rash, increased asthma, anaphylaxis (a life-threatening reaction), and gastrointestinal side effects. Can thin the blood as aspirin does, which may be problematic before and after surgery. Interferes with the HIV medication saquinavir. May lower blood glucose levels. May cause irregular menstruation and high blood pressure. May increase bleeding risk, so people taking anticoagulants, those with bleeding disorders, or those going into surgery shouldn't take it without a doctor's guidance. Raw ginkgo seeds may cause an allergic reaction ending in seizures or death.
Take Home Message? Ask your doctor before taking any supplements, particularly if you are taking other medications.
Outside 3124: Locked Out!
Community Story Corner with Lee Leon By: Junuen (Junie) Galindo, Media Intern
Lee Leon has been the custodian at NAHC in 3124 International building. He witnesses some of the most extraordinary and outrageous things on International Blvd. and knows how to recount them in an enthralling, funny, and soulful way. This is our Community Story Corner with Lee Leon… “One story comes to mind. It happened a couple years ago. One of our co-workers was having an interview with his client and so after he finished up and I guess he was doing his paper work. His client took off and he was left doing paper work. He finally decided to go home, walked down the stairs and went through the front door. Once he walks out and closes the front door he sees the gate and realizes he’s trapped. So, the only way he got out was because of the alarm system. When the alarm system went off Bay Alarms called my boss and Bay alarm and said, “There’s some movement in the building should we bring the cops over to come check it out or are you guys going to come check it out yourself?” So, since my boss was out of town at the time, out of state actually, she calls me to come check it out and sure enough he was stuck between the front door and the gate. And there was more to it than that! While he was down stairs and he was waiting for somebody to show up he asked a few prostitutes to help him out. He’s banging the door “Madam, can you help me? Can you at least talk to the manager at Wendy’s and tell him there’s a guy here stuck in the building”. They said, “Well I can’t do it because I have a beer in my hand! Well, I can try”. So they go over to Wendy’s and tried to talk to the manager. The manager yells at them “Get out, you are drinking, I don’t believe you”. “No I’m serious there’s a guy stuck between the front door and the gate you need to call the cops”. So since the alarm went off I had to come down and rescue him. At least a good hour. This happened at approximately 6 o’clock. When he asked me for the time, I said, “It’s a bit after six” and then he said, “Oh man! I have an AA meeting to go to”.
Sage Gathering for G.O.T.L. By: Junuen (Junie) Galindo, Media Intern My first day as an intern at NAHC, I walked into a room full of community members tying sage. I felt clear, and good, there was a familiar, earthy smell inside of the 3124 building that filled my senses and mind completely. This article catalogues the meaning of sage, the journey to get the sage, and sage’s role in the annual Gathering of the Lodges (GOTL).
Sage
Martha Martinez, Cultural Facilitator spoke to me about the meaning of sage. Sage is considered a medicine of purification. It is generally used to smudge, meaning to burn the sage, or sometimes in teas or other methods depending on one’s traditions. It is also used to prepare for ceremony. Once one burns sage they cleanse out all the negative thoughts or energy around them in order to be grounded and fully present for the ceremony. The sage balances the four quadrants of the Medicine Wheel - emotional, physical, mental, and spiritual aspects of one’s overall health. Ceremonies such as GOTL sit at the center of the medicine wheel. It can be a challenge in life to slow down; sage allows us to do that. It helps remind us of the gift of life. Sage prepares us to be in a state of
reverence, and respect, in order to better hear and understand ourselves, our relatives, our lives, and our connection to the Creator.
Gathering Sage
10 NAHC employees traveled six hours away to Ojai, California to pick the sage that was grown and cultivated for the community, which happened at the end of May this year. To properly and respectfully pick the sage the group participated in a traditional process. They offered tobacco, and prayed in order to prepare themselves to pull the medicine from the earth – only pulling in places where it does not hurt the plant. The trip was profound to those who participated because it brought together co-workers in nature, in tradition, and in ceremony. The group may have only picked for one day but they came back with 23 burlap sacks filled with sage. On May 31st and June 1st the community came together to tie and bundle the sage. As Larry Aguilera describes the event, “It was a blessing to see the entire community come together for one task”. Once the 23 sacks were empty there were 1,158 bundles of sage left to dry in Larry’s office.
Sage and the Gathering of the Lodges
Martin Wakuzoo describes the event as “More than an event, it’s a statement; a statement of moving toward wellness. It’s a celebration of recovery in our community” Kitty Budd adds, “It’s also a place to encourage and open up to others. It is a seed of hope”. More importantly it is a “time where the Native community comes together and honors those who have achieved or are pursuing a sober and healthy lifestyle”. GOTL incorporates sage by using it in the morning and throughout the day to smudge the room (space). During the sobriety countdown, members of the community are called up and given a coin and a bundle of sage to honor their sobriety. Then an honor song is offered and there is a round dance. Throughout the day there are workshops. The workshops this year include an art workshop with Sam English and various meetings with community members around the topic of sobriety.
Gratitude We would like to thank the following NAHC community members for making GOTL possible and keeping it alive for 11 years. Veda Gamez, Kathryn Budd, Nina Gutierrez, Kateri Chiu, Chirag Patel, Katherine Lewis, Angelena Tsosie, Serena Wright, Tommy Orange, Lina Blanco, NAHC Media Interns, Jordan Skye Paul, Youth Services, Violet Lundberg, Martin Waukazoo, Ethan Nebelkopf, and Friendship House Association of American Indians.
AIDS Walk SF 2012 By: Media Interns The 2012 San Francisco AIDS Walk brought together an estimated 15,000 participants in a collective effort to support services related to HIV/ AIDS. Representative Barbara Lee and Lieutenant Governor Gavin Newsom were in attendance along with 47 AIDS organizations. Team Native American Health Center brought 10 participants to the walk, donning custom T-Shirts for the occasion. NAHC pledged to fundraise $1,000, and thanks to 20 donors, was able to exceed the goal and raise $1,600. The total amount of funds raised with the participating organizations exceeded $2.5 million. The Native American Health Center’s Circle of Healing has been involved with the AIDS Walk for three years and it coincided with the National HIV Testing Day on June 27. The Circle of Healing is also considered a ‘safe haven’ for Two-Spirit people who need safe space to comfortably embrace their identity. There are currently 1.2 million people in the United States who live with HIV/AIDS, and the amount of people in attendance is a good sign for the future. Istuyee Montez, the designer of the T-Shirt, says, “This is not hers, his or their fight alone, but this is our fight.” With the success of the this year’s Walk, NAHC looks to build upon the energy and have a greater presence in next year’s effort. *The Native American Health Center is dedicated to the health of the community and offers free HIV testing in San Francisco as well as many local events such as Pow-Wows and community events.
SF Dental Updates The Dental department in San Francisco is providing dental screenings for adult and children at different community-based sites for the month of August. NAHC Dental will be at the Family Health Fair in the Homeless Prenatal program on August 3 during the afternoon. NAHC Dental will provide dental education for the children and their families as well as provide information about dental services and how to access care. On August 15: We will be at the Raphael House a shelter for children and their families during the morning. On August 29: We will provide dental screenings for the Hamilton Family center during the afternoon
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NAHCMedia@nativehealth.org with the
Title line “@NAHC (Title of your Piece)” by the last Friday of the Month!
Where is your Stay-cation? Thank you for your responses! These were from you contributions. We wanted to poll where one “stay-cates”. “Stay-cation” is a term to describe where one may go in their local area to escape or feel like they are on vacation. Because it is almost the end of summer some may still have a few days of vacation left to spend but do not wish to travel far.
Thank you for sharing your favorite place to retreat within your area! Nearby
Not-So-Nearby
Farther Away
You’re the Future, Our Native Youth! Stay tuned for more of the beautiful photos taken for our Native Youth Wellness Initiative Project led by our very own Native Youth who strive to prevent suicide in our communities. WE HIGHLY ENCOURAGE YOU TO EXPRESS YOURSELF ABOUT THE ISSUE AS WELL AS TELLING US YOUR STORY/ CARD EXPERIENCE. You may do this anonymously or through your personal tumblr url. For more information, please visit our Tumblr: http://you-are-the-future.tumblr.com
Congratulations to our NAHC staff for volunteer efforts at the Bayview Opera House Health Fair Day on their successes and HIV testing booth that was provided at the event. Great job team!