Carolyn M. Shepherd, MD, Medical Director, Clinica Campesina;
Amy H. Russell, MD, Assistant Medical Director, Clinica Campesina

      This session will describe how Clinica Campesina, a busy community health center, has made and sustained major changes inthe processes of providing care to the uninsured and poor since 1998. The current challenge of continuing to refine the systems of care and maintain the enthusiasm for change and improvement will also be discussed.
      After this presentation you will be able to:

• Describe the common barriers for sustaining meaningful change inquality of care.
• Review processes and structure needed to support the organizational culture of redesign.
• Plan how to maintain the enthusiasm through the life cycle of change.