Penn Presbyterian & Trauma Transitions
September 2014
Special All Employee Meetings
Today’s Session Highlights
 Penn Medicine University City
 Campus Security & Parking
 Human Resources plans
 Patient care unit changes timelines
 Service and support changes
 Preparations and orientation to transition
 New trauma process operations in development
 …Ask the audience
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Penn Medicine University City
 Now Open – Penn Medicine’s Newest Outpatient Center
 HUB site for the Penn Musculoskeletal Center
 PMUC intranet page with details of operations of building
 Average Daily Impact of Activity Shifting from PPMC to 3737 Market:
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Surgery
Cases
122
Medical
Imaging
Visits
300
Clinic
Visits
140
Therapy
Visits
360 staff
and
faculty
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Penn Medicine University City Occupants
Floor
Department
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• Penn Neurosciences Clinic (Neurology & Neurosurgery)
• Penn Musculoskeletal Center (Orthopaedics & Rheumatology)
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• Medical Imaging, Outpatient Lab & EKG, Neurodiagnostic Lab
& Non-Invasive Vascular Lab)
• Penn Musculoskeletal Center ( Orthopaedics, Pain Medicine;
Sports Medicine )
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• Administrative Offices & Faculty Offices
5
• The Surgery Center at Penn Medicine University City
4
• Surgery & Urology
• Penn Mesothelioma & Pleural Program
3
• Allergy & Immunology
• Endocrinology, Diabetes & Metabolism
• Otorhinolaryngology
2
• Penn Therapy & Fitness Physical Therapy
1
• Retail Pharmacy
Note: Floors 9 and 10 will be occupied in the spring of 2015
4
First Renovations at PPMC opening
Half of the Emergency Department
Renovations for the new
Reception and Triage area have
opened along with the new MRI
suite
• (4) Test & Evaluation Rooms
• Bereavement Room
• Reopen side entrance to the
ED (former ambulance
entrance) for all traffic
•
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2 (1.5T MRI) & control room
Inpatient holding
Prep consult space
Radiologist reading room
Male & Female changing
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Safety Enhancement - Crosswalk 38th Street
 The opening of Penn Medicine University City has increased
pedestrian traffic crossing midblock between the main campus and
Filbert Street
 City Traffic Engineering has approved the crosswalk plan which
will be constructed this fall
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Security Enhancements
Team
• Penn Police officer stationed outside the emergency
department day and evening shift
• 12 additional full time staff joining the PPMC security team
• Additional officer posts positions
Skills
• Handcuff and baton carrying
• Aggression management
• Act 235 certification for enhanced control of situations
• Crowd control methods
Facility
Response
• Metal detector at emergency room
• Panic buttons at reception desks/nursing station
• 4 PAC and 4 Cupp secured access unit with video monitoring
• Video monitoring throughout
• Additional staff will allow for increase incident response time
• Enhanced rounding and expanded coverage hours
• Security coverage is consistent with HUP and other Level 1
Trauma Centers coverage
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Staff Parking at PPMC
Penn Presbyterian Campus
Parking is located currently in
five locations:
1. Powelton Lot
2. Scheie/3910 Lot
3. Rudolphy Lot
4. Main Parking Deck
5. Fresh Grocer Parking
Free Employee Parking:
-
In after 2 PM & out by 9AM
All Weekend
Main Parking Deck
Must have PPMC ID badge
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Staff Parking at PPMC
 Patient parking for Penn Medicine University City is now
available at the connected garage servicing the 3737 location
 No additional parking structures have been built
 Rudolphy lot will be converted to a patient lot and staff parkers
in that lot will be accommodated in other campus lots (Fall 2014)
 Staff requests for parking are being accommodated currently in
the Fresh Grocer garage located at 40th & Walnut
 Currently parking rate for the 40th & Walnut location is
$169.08/month rate which is the standard University rate
 Shuttles are provided to the campus between 5 AM to 9:30 AM;
and resuming from 3:30 PM to 9:00 PM on continuous loop
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4 East - Trauma Bed Unit Renovations
In preparation as the Trauma Med Surg Bed Unit the following
renovations are taking place beginning in September 2014
through November 2015 on Cupp 4 East:
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Patient lift installations
Resident work room construction
Staff locker reconfiguration
Family waiting room construction
Secured unit card and camera installations
4 Wright Saunders Gym
Patient room additions (2)
Cosmetic renovations
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Trauma Transition Guiding Principles
Ensure Trauma competency transfer to meet
the patient needs and ensure Trauma
Foundation compliance
Ensure a smooth integration of combined
PPMC teams and new job roles. Retain and
expand PMC staff as well as increase skills
and competencies as needed to support the
trauma patient and new care requirements
Mitigate any Human Resources differences
between entities as barriers to transfer and
retention. Develop an easy process for job
role transfer
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Hospital Staff Impact FY15
Well resourced to support the care of the trauma patient as well as
increase PPMC capacity to 24/7 operations and the new Pavilion
occupancy expansion
HUP Nursing
Transfers
156 FTE
HUP Non-Nursing
Transfers
53 FTE
328 Staff
Impact
99* FTE
PPMC Non-Nursing
Recruitment
* Includes
20 FTE
PPMC Nursing
Recruitment
20 advanced practice providers
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CPUP Incremental Expansions for FY15
In addition to the existing faculty and staff at PPMC several
departments expanded staff to ensure 24/7 provider depth
coverage and to facilitate new program growth
Department
TOTALS
Faculty/Residents/Fellows
• 14.1 FTE Faculty
Anesthesia Critical Care
• 5.1 Faculty
Emergency Medicine
• 3.0 Faculty
Medicine – Infectious Disease
• Additional call
Neurosurgery
• 0.5 Faculty
Neurology-Neurocritical Care
• 1.0 Faculty
Otorhinolaryngology
PM&R
1.0 Critical Care Fellow
1.0 Resident
•
Neonatology
Obstetrics
7.0 Residents/Fellows
1.0 Fellow
1.0 Fellow
• Additional call
1.0 Resident
•
1.0 Resident
• 1.0 Faculty
Radiology – Interventional Rad. • 1.0 Faculty & additional call
Surgery
• 2.5 Faculty
1.0 Critical Care Fellow
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Human Resources Programs
• Base Pay Compensation program will be the same
•Benefits program is the same including Tuition and Paid Time Off programs
•Certification and Preceptor bonus pay will be standardized
•Allied Health job requirements will be standardized
•Alignment of Shift Differential policy and rates
•Registered Nurses will transition to Exempt/Professional model
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Transition Guide
Staff and faculty transitioning will be provided with a coordinated
guide to assist in the welcome to the PPMC campus in the upcoming
months.
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PPMC ID badge
Parking coordination
Campus orientation
Department orientation
Uniform
Team integration and development
Manager introductions
Employee file transfers
AU and payroll transition
Personal space/office item moves
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2014 Campus Transition Timelines
Penn Medicine University City opened; HUP based MSK Radiologists &
HUP Orthopaedic faculty and staff transition to campus with this move
Aug
Fall
2 new 1.5 T MRI suite at PPMC - Temporary MRI trailer closes
Fall
Fall
Fall
Dec
Dec
Cupp 3 East and 3 South service line shifts
Rapid Assessment and Treatment opens in the Emergency
Department – 1 Myrin
New recruits for PAC opening begin
Trauma Program Staff and Faculty Offices move from HUP
Eye Emergency Suite open 24/7 in Emergency Department
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2015 Campus Transition Timelines
01/05/15
SICU moves to new home in 4 PAC Trauma Surgical Critical Care Unit
01/10/15
01/12/15
01/19/15
4
01/26/15
5
01/29/15
02/04/15
PACU/SPU move to new 2 PAC home
ED expansion opens and the MICU moves to 2 Myrin and
Neurocritical Care service begins in 4 PAC unit
CCU moves to new 3 PAC home
New complete Heart and Vascular Unit begins with move of CT
patients to new 3 PAC unit
Observation patients move to 3 Wright Saunders (former CCU space)
Trauma service begins, PAC Helipad opens, and HUP staff transition
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PPMC Service Enhancements
Many of the service and facility enhancements on the horizon enhance
the patient care experience for ALL of the PPMC patients and providers
Medical Imaging
and Lab waiting in
new Concourse
All radiology
modalities in new
consolidated
facilities
Neurosurgical and
neurocritical care
services
Expanded food
service options with
addition of new café
Dedicated
Observation unit
New Inpatient
therapy gym
Emergent 24/7 Eye
Injury treatment in
Emergency
Department
Enhanced Surgical
Patient & family
experience
Rapid Assessment
and Treatment
pathway for
Emergency
department patients
Expansion of
Critical Care
capacity at PPMC
Expanded consult
services
New welcoming
Cupp lobby and
Concourse
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Preparing Teams for Transition
 Learning the process of Trauma Care is being facilitated via
multiple skill sessions including :
• HUP Onsite Observation/Preempting;
• Skills sessions & formal didactic course;
• Scenario based simulation at SIM Center;
 New Pavilion Orientation
• Unit and ancillary staff in new PAC
• Life safety and unit orientation/process flow
 PPMC Need To Know Orientation for All Staff
• Pavilion Navigation and Orientation
• New campus service expansion
• Trauma and Injured Patient Awareness 101
 Simulation will be conducted following the path of the patient
in the new PAC facility
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Team Structure and Integration
 Staff transitioning from HUP will retain their seniority and
tenure from date of hire to the health system
 New team members will integrate with the PPMC teams
 Some departments may have changes to shifts and team
assignments as the new team structures are identified
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“Hidden” Transition Challenges
 Replication and expansion of services to support the trauma
patient outside of HUP has been the focus and measure of
success in our transition readiness.
 Areas where HUP has had historically limited patient demand
have required us to think more creatively about how to serve
these patients in the new trauma environment at PPMC:
Pregnant Patients
Neonatal and
Pediatric Patients
Inter-facility Transport
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Rapid Intercampus Staff Transport Plan
 The Rapid Intercampus Staff Transport (RIST) protocol was
established for emergency staff mobilization
 Facilitated by the PPMC and HUP security offices
 Staff member place call to campus dispatch number
 Transport pickup within 15 minutes of call
 Designated pickup location at each campus
 Activated 24/7
 Transport vehicle fleet expanded to accommodate demand
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Scenario Simulations
Patient simulation scenarios will assist teams to practice many of
the new clinical situations that the PPMC campus will encounter.
Security
Scenarios
Trauma
impact to
OR cases
Patient
transport &
Bed Flow
Blood
transport
and order
Pediatric
trauma
patient/
neonate
pediatric
patient
Family
management
in Trauma
Bay
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PTSF Survey Cycle
Date
Event
November 4, 2014
Survey (EAFS) Application Due
(Inc documentation reflecting % of nursing and physician
staff transitioning and demonstration of their trauma
education and competency)
November 14, 2014
Questions on survey from PTSF to HUP
December 3, 2014
Question responses from HUP to PTSF
Early December
PTSF update to PTSF Board regarding areas of non
compliance which may require action plan
December 11
Medical Record pull discussion with Policy and Procedure
Committee
February 4, 2015
Move
April 3, 2015
Survey (EAFS) due from PPMC
April 14 -15, 2015
Tentative MOCK survey site review
April 24, 2015
Questions due from PTSF to PPMC
May 8, 2015
Question response from PPMC to PTSF
June 24, 2015
Site survey PPMC : 4 Team membe
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HUP after February 4th Trauma Move
 02/04/15 effective midnight Level I Trauma Center program and
designation will transfer to PPMC.
 HUP will no longer be an accredited trauma hospital
 Ground and Flight ambulances must transport major trauma
patients (patients with severe injury that threatens life and limb)
to a level I or II trauma hospital within 30 minutes transport time
 These EMS and Police/Fire Rescue transported trauma patients
will be taken to PPMC.
 Today over 200 trauma patients arrive to HUP by “private vehicle
or walk in” - the message to these patients that the formal Level I
Center has moved will take time to redirect…
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HUP Emergency Surgical Services Capacity
As a major academic medical center HUP will continue to have
the resources to provide multidisciplinary treatment and
specialized resources for emergent and injured patients.
Emergency
Department
In-House
Trauma
Surgical
Attending
Emergency
Surgical
Services
Surgical
Critical
Care
 HUP retains ability to mobilize in-house resources to treat or
transfer a severely injured patient that requires emergent
treatment / management of all surgical emergencies efficiently
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Ask the Audience…
Please get out your phone
Open your messaging app
Create a new text to: 22333
https://www.polleverywhere.com/my/polls#!/my/polls
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