Learning & Implementation Process

Step 1: Education and Learning

All LiveHealthy OC clinics will participate in a planned education and learning program with a focus on educating physicians, mid-level providers, medical assistants, and clinic staff. The education and learning program is intended to achieve the following outcomes:

  • Understanding of the evidence behind and fundamentals of health creation and wellness delivery models, including such sub-topics as: group visits, motivational interviewing, and paired visits, to provide the clinic cohort with a deeper understanding of specific integrative health practices.
  • Knowledge and tools related to developing an Integrative Health program within a clinic setting.
  • Guidance on the cultural, systems and operational changes that will need to occur within clinics to successfully embed integrative health practices within the clinic setting.
  • One-on-one mentoring of cohort members by Project Team during testing and implementation.

Intended Outcomes of Step 1:

  1. Improved knowledge and skills of the foundations of health creation and wellness
  2. Improved knowledge and skills in the use of integrative modalities applicable for common primary care issues
  3. Improved the capacity for clinics to initiate innovative strategies for community health and wellness, such as paired visits and group medical visits.
  4. Improved communication skills for physicians to support healthy lifestyle change (e.g., facilitation of group medical visits, motivational interviewing and health coaching).
  5. Increased knowledge and skills on the systems and operational changes necessary to introduce transformation systems change within their clinic setting


Physicians, mid-level providers, medical assistants, and clinic staff will receive instruction, best practices and individualized guidance on how best to introduce Integrative Health into their operations. Recognizing that the efforts within individual clinics will vary based on current integrative health programming on site, staffing and operations, and patient needs, the Initiative will continue to introduce a range of evidence-based integrative health modalities and strategies. Topics for discussion will include, but not limited to: financing and sustainability approaches, internal communications, alignment with FQHC scope of services and risk management. Various subject matter experts have been working closely with the project team to share this information.

Specific educational activities will include:

  • Access to a 45-hour inter-professional online curriculum created by the National Center for Integrative Primary Healthcare (NCIPH) specifically designed to teach evidence-based principles and best practices of Integrative Healthcare for Primary Care Providers.
  • Interactive workshops and seminars on practical tools and skills in Integrative Medicine. These sessions have included in-person workshops, web-based learning (webinars, podcasts and videos) and utilized a variety of integrative physician and allied health experts.
  • Topics for these educational sessions include:

Skill Building Workshops

  • Conducting group medical visits
  • Motivational interviewing to support healthy lifestyle change
  • Health coaching
  • Simple manual medicine techniques for myofascial pain
  • Basic mind-body breath relaxation techniques
  • Financing strategies

Knowledge Building Seminars

  • Nutrition and healthy diet for low income families
  • Evidence-based use of herbals and supplements for primary care conditions
  • Supporting healthy sleep
  • Patient case studies – applying Integrative approaches to primary care problems
  • Operations: Best practices from existing Integrative Health clinics

 Experiential and Knowledge Building Workshops

  • Acupuncture
  • Yoga and Tai Chi
  • Osteopathic Manipulation Therapy
  • Healthy cooking
  • Mindfulness Based Stress Reduction (MBSR)
  • Healing Touch

For the Skill and Knowledge Building Workshops, physicians, mid-level providers and medical assistants who successfully complete training programs, will receive American Medical Association (AMA) Continuing Medical Education (CME) Credits.  Participants have the opportunity to receive up to a total of 62.0 AMA CME Credits from the LiveHealthy OC Initiative curriculum learning and education programs.

Step 2: Transformational Change in Culture, Practice and Service Delivery

All clinics will engage in a supported process to identify the transformative change strategies needed within the clinic setting. Each of the clinics will assess its strengths and the needs of the clinic and population served and the select specific practice changes for implementation. Clinics will receive support and coaching from the project team that includes the Process Improvement Coach, Project Manager, Outcomes Researcher, and the Initiative’s Principal Investigator.

Testing and initial implementation of the strategies within the clinics will utilize the Institute for Health Improvement Breakthrough Series approach. All clinics will conduct two rounds of Rapid Cycle Change Processes (PDSA – Plan, Do, Study, Act) within their clinic settings. As part of the implementation and testing, each clinic will receive the following support:

  • Guidance and support from the Process Improvement Coach, Project Manager, Outcomes Researcher, Principal Investigator and other cohort members in the form of regular cohort meetings, phone calls, coaching, site visits, and monthly progress  reporting.
  • Integrative Provider Resources from the Susan Samueli Center for Integrative Medicine (SSCIM) at UC Irvine available to clinics for the duration of the Initiative.
  • Logistical and in-person support from the Health Scholars Program. Up to three Health Scholars will be assigned to each of the participating clinics to support the integrative health practices occurring within the clinics and work directly with clinic patients as “Health Connectors.”

Step 3: Cultivating a Professional Learning Community

At the heart of this initiative is the creation of a countywide community of practice and learning. It is this ongoing platform for peer-to-peer driven learning that will help to create the sustainability of the Learning Community effort. All clinics will participate in the collaborative learning community which provides the following:

  • Professional exchange of best practices among the cohort that focus on providing comprehensive health and wellness services and supports for the economically disadvantaged communities throughout Orange County.
  • Increased opportunities for clinics to share information and inform the practice and service delivery field through conferences, presentations, and peer-to-peer modeling/coaching experiences.

Throughout this process, the participating organizations will be building and participating in a peer-based professional learning community. All clinics will attend quarterly scheduled Community of Practice (COP) meetings, facilitated discussions, and a peer-to-peer collaborative learning group.

Participation in Peer-to-Peer Learning

Peer to peer learning represents a core component of any successful long-term collaborative, as well as serving as an important piece of the Initiative’s sustainability. All clinics will join together expanding the Community of Practice, and begin developing a mentorship and deeper peer-to-peer learning model. Clinics will learn from each other, and each will receive evaluation and assessment tools that will allow for both internal and external learnings.