Penn Presbyterian Transformation The Next Chapter…What It Means To You March 2014 PPMC Special All Employee Meetings The Journey Has Begun! One year ago : - Preparing for groundbreaking of the Pavilion for Advanced Care - Laying the foundations for the now 13-story Penn Medicine University City - Defining the resources & skills, and talent staff needed in 2015 Today: - Watching the campus and skyline of PPMC change daily - Days away from the ribbon cutting of the newly renovated Scheie Eye Institute - Fine tuning the plans, people, and process needed in the months ahead One year from now: - Occupying two gorgeous new buildings on the campus - Welcoming trauma patients through our as the Level 1 Trauma Center at Penn - Performing Neurosurgical and Orthopedic Trauma cases on the campus - Launching EPIC in our radiology and ED departments 2 Our Pavilion for Advanced Care and Penn Medicine University City are transformative structures for Penn Medicine as well as the revitalization of 38th Street. 3 March Construction Update January ‘14 October ‘13 August ‘13 Penn Medicine University City June ‘13 4 March Construction Update Pavilion for Advanced Care Steel Topped out – Feb 28th Exterior skin started Stud framing and mechanical, Electrical and plumbing started 5 6 First Patient Schedule – August 2014 8/4 Retail Pharmacy, Lobby, Security GSPP Physical Therapy and Offices 8/11 8/24 Allergy & Immunology Clinic & Offices Orthopaedic offices only Otorhinolaryngology Clinic and Offices Ortho Spine & Hand Clinic 9/8 Remaining offices (MSK Radiology & PPMC Rheumatology) Board Room Ortho Trauma (HUP) Clinic CPD/Support/ Materials The Surgery Center at Penn Presbyterian Surgery and Urology Clinic Medical Imaging & Diagnostic Services Ortho Shoulder & Joints Clinic Rheumatology Clinic Neurosciences Clinic MSK Radiology Reading Rooms Radiology (X-ray) 3,200 OP surgical cases shift from PPMC to new Surgery Center & GSPP closes therapy site at 3624 Market A&I from Mutch 6 Oto from MOB 3 Surgery from W/S 2 Urology from MOB 2 Mammography from W/S 3 Pleural Program Practices close & move: Ortho from Cupp 1 and HUP Silverstein Rheum from 3910 Neurology from MOB 3 New duplicative Services established : MRI, X-ray, EEG, registration, EKG Ultrasound, Vascular Lab, Phlebotomy, Outpatient Pharmacy Practices close and move: MSK Radiology from PCAM Ground 7 PPMC Campus Impact of Opening The opening of Penn Medicine University City is projected to shift from the main Presbyterian campus: 68,000 annual outpatient clinical practice visits All PPMC Mammography and Dexascan screenings 3,200 outpatient surgical cases A portion of… outpatient medical imaging (x-ray, ultrasound, MRI) non-invasive vascular lab, EKG, EEG, outpatient phlebotomy, outpatient pharmacy 64 faculty – from orthopedics, neurology, allergy & immunology, otorhinolaryngology, surgery, urology, rheumatology & neurosurgery 192 staff – including 40+ new hires in the hospital based areas Patient parking tied to the above noted visits 8 New Programs Accommodated Via Moves Vacated space due to University City moves allows for new and expanded programs on the main campus.. New /Expanded Program Plans Space Opening Third Interventional Radiology Lab W/S 4 July 2014 Pathology central receiving & Blood bank renovations W/S 5 December 2014 CPUP Neurosciences faculty offices for neurosurgery, neurocritical care, and neurology TBD Dec 2014 Penn Trauma program staff, advanced practitioner and faculty offices from HUP MOB 1 Dec 2014 Call Room suite for trauma and sub-specialists W/S 4 Jan 2015 Combined faculty offices for the Department of Surgery with Urology Division W/S 2 Dec 2015 Acute Care Research collaborative program research space Mutch 3 TBD Space Closures/ No Backfill Space PPMC Rheumatology 3910 9 Campus Renovations Underway MRI Suite ED Rapid Triage Intake • Davita dialysis relocated in January to make way for the 2 room – MRI suite Complete July/August 2014 OR 16 • ED registration and part of the lobby and entrances are under renovation Complete July 2014 • The MRI has moved to a temporary trailer in Myrin Circle to make way for the construction of the concourse and OR16 on the 2nd floor Complete December 2014 10 Pavilion for Advanced Care Occupancy 2015 Patient Occupancy: SICU (4th) HVICU (3rd) PeriOP (2nd) ED expansion (1st) CT (1st) (2 units) Trauma Unit (training) January 4 January 4 January 10 January 12 January 12 January 6 Surgical Critical Care Heart and Vascular Critical Care Perioperative Services Cupp 1 Medical Imaging OR and Critical Care Pharmacy Emergency Department Trauma Resuscitation New construction completion anticipated November 17, 2014 allowing for equipment, furniture, IT , stocking and staff training and licensure activity. 11 Trauma Center at Penn Presbyterian We have set a date to move the Level 1 Trauma Center PPM FEBRUARY 4, 2015 12 Penn Presbyterian Transformation In addition to the unit transitions to occupy the new Pavilion for Advanced Care several internal main campus units and patient population moves will also occur. Allows for service line consolidations and co-location of the general acute care population on the campus Enables staffing & resources as a “full capacity organization” TODAY Licensed Beds Ave. Daily Census 2015 305 Acute Care, 26 SNF +26 Acute Beds Acute 197, SNF 17, Total: 214 +47 ADC Occupancy 72.9% 79% Occupancy Admissions 15,982 +2562 Admissions Surgeries 13,187 +2447 Surgeries ED visits 39, 556 +7000 ED/Trauma Visits 13 Penn Presbyterian Internal Transitions Current State Next Chapter 5 East Orthopedics, General Med/Surg Orthopedics, Ortho Trauma, Neuro/Gen Surgery 5 South Orthopedics, General Med/Surg Orthopedics, Ortho Trauma, Neuro/Gen Surgery 4 East Thoracic, Stroke, General Med, and Observation General Care Trauma Unit 4 South Medical Medical 3 East Cardiac Surgical Cardiac Medical/Surgical 3 South Cardiac Medical, Heart Failure/Pulmonary Hypertension Heart Failure, Thoracic, Stroke MICU Medical OR Locker Room/Office Space SICU General Surgery, Orthopedics, CT & Vascular Surgery MICU CCU Cardiac Critical Care Patients/Heart Rescue Observation Unit 14 Penn Presbyterian Internal Transitions Current State Next Chapter ED PAC 1 20 patient rooms plus overflow 33 ED beds, plus 2 ED resuscitation & 5 Trauma resuscitation bays & 5 Rapid Triage Area rooms PACU/SPU PAC 2 Separate Units Combined Unit/Prep & Recovery - Improved Patient Flow Patient Experience PAC 3 Heart & Vascular Intensive Care Unit PAC 4 General Surgery, Neuro Surgery, &Trauma Intensive Care Unit PAC 5 Neuro Surgical Intensive Care Unit (FY16) 15 Preparing Teams for the Transitions New Building Orientation Orientation & Training Classroom Instruction 5 East X X 5 South X X 3 East X X 3 South X X MICU X X Endo X X Resource X X X X PAC 2 X X PAC 3 X X X X X X 4 East PAC 1 PAC 4 ASF X X X Total Education Expenses Exceeding 1.8 Million 16 PPMC Nursing Leadership Team James Ballinghoff MSN MBA RN Chief Nursing Officer Magnet Program Director Nursing Shared Governanc e Clinical Director of Trauma & Orthopedics Clinical Director, Emergency & Medical Nursing Clinical Director, Heart & Vascular Nursing Director, Nursing Education & Research Clinical Director, PeriOp Nursing PAC 4 SICU/Trauma ED/Trauma PAC 3 Heart & Vascular Intensive Care Unit Educators Main Operating Room PAC 5 SICU/Neuro MICU 3 East Cardiology Med/Surg 4 East/ Trauma 4 South General Med 3 South Heart Failure, Thoracic 5 East/Ortho ACE Geriatrics Observation W/S 3 5 South/Ortho Wright 5 Psych Nursing Admin Coordinators Occupational Medicine Wright 4 Detox Core Councils Ambulatory Surgical Facility Scheie Operating Room PAC 2 SPU/PACU ENDO Nursing Resource Center IOP 17 New Unit and Team Transitions We are anticipating 200 FTEs from HUP to transition to PPMC for February 2015 start dates 72% of the transitioning staff are in the Department of Nursing All teams will experience a blending of staff, some more than others Team structure and blending will take into account the following criteria such as competency to serve the patient population, Penn Medicine seniority and compliment of current shift schedules After the FY15 budgets are finalized in April we will know volume allocations and can provide firm details on unit staffing -- WE NEED YOU – PLEASE GIVE US AN OPPORTUNITY TO PROPOSE OUR PLANS WITH FIRM DETAIL 18 Transitions Timing and Education Mar. Apr. May June July Define areas at All employee meeting Aug. Sept. Oct. Nov. Dec. Jan. Feb. Education for Staff Group Interviews led by CMO/CNO pairs Staffing plans finalized PAC building is turned over •RN Professional Exempt model begins •Shift Diff Changes implemented SICU to 4 PAC CCU to 3 PAC Obs. To Cupp 3 SPU/PACU To PAC 2 ED exp. to PAC 1 MICU to 2 Myrin Penn Medicine University City opens PeriOp, hospital operations and CPUP staff move 4 East Trauma 1st Trauma patient seen at PPMC 19 Transition Details - Human Resources HUP staff have committed to transition to PPMC by signed letter Mitigate any Human Resources differences between entities as barriers to transfer and retention to PPMC payroll and internal transfers as a result of our transition Working to ensure a smooth integration of combined PPMC teams and new job roles New hires are anticipated for both buildings and positions will be posted Human Resources programs in development: Base Pay Compensation program will be the same Benefits program is the same including Tuition and Paid Time Off programs Shift Differential policy and rates will be equal Certification and Preceptor bonus pay will be standardized Registered Nurses will convert to Exempt/Professional model Allied Health job requirements will be standardized 20 The Next Round of Details We anticipate a 3rd round of All Employee Meetings to take place in mid-summer Topics for that session will explore in greater detail the plans for Human resource program details and timing Parking plan details Campus security after the Trauma move Transportation between HUP & PPMC Traffic and pedestrian plans around campus 21