Penn Medicine Trauma Center Transition Increasing Our Capacity to Care November 2013 HUP All Employee Meetings.
Download ReportTranscript Penn Medicine Trauma Center Transition Increasing Our Capacity to Care November 2013 HUP All Employee Meetings.
Penn Medicine Trauma Center Transition Increasing Our Capacity to Care November 2013 HUP All Employee Meetings The Trauma Center at Penn The Trauma Center at Penn Presbyterian Medical Center will become Penn Medicine’s Level 1 Regional Resource Trauma Center early in 2015 The Pennsylvania Trauma Foundation will recognize the 25 year history of the Penn Trauma Program as the Same Program in a New Location The Trauma Program at Penn Presbyterian will continue as a: Level 1 Regional Resource Trauma Center Consistently accredited since 1988 National & international model of excellence in trauma and surgical critical care. Regional resource treating over 2,000 injured patients annually within southeastern Pennsylvania, New Jersey and Delaware Program characterized by high patient volume, higher injury severity, and favorable outcomes as validated by external benchmarks 2 Increasing our Capacity to Care Moving the Trauma Program at Penn to PPMC is part of a larger strategy to invest in campus infrastructure expansions at each hospital to optimize inpatient capacity across Penn Medicine. Pennsylvania Hospital (PAH) OB/GYN Orthopaedics Neurosciences Penn Presbyterian Medical Center (PPMC) Cardiovascular Ophthamology* Orthopaedics Hospital of the University of Pennsylvania (HUP) Cancer Neurosciences and others Cardiovascular Transplant Our big-picture strategy includes maintaining significant anchor programs with critical inpatient mass at each hospital, in order to achieve additional bed capacity. *PPMC’s Ophthalmology Program does not have a significant inpatient footprint. 3 Penn Presbyterian’s “Trauma Transformation” Volpe Founded in 1871, with 45 beds on 2.5 acres now a 16 acre campus Licensed Beds Ave. Daily Census 305 Acute Care, 26 SNF Acute 197, SNF 17, Total: 214 +26 Acute Beds +47 ADC Occupancy 72.9% 79% Occupancy Admissions 15,982 +2562 Admissions 13,187 +1284 Surgeries 39, 556 +7000 ED/Trauma Visits Surgeries ED visits Rich History, Bold Future 4 The Trauma Center at Penn Presbyterian PPMC is excited about the trauma program Emergency Medicine Compliments our services Elevates our care to a “state of constant readiness” Supports our community Increases our capacity Expands our team Allows us to grow We need YOU to join us in building the next chapter of the Trauma Center at Penn Presbyterian for our patients. Radiology/ Interventional Radiology Allied Health Professions Physical Medicine & Rehab Surgical Critical Care Nursing Trauma Surgery Anesthesia Neurosurgery Orthopaedics 5 A Collaborative Team Planning Process Physicians Joint process of partnering HUP and PPMC managers, and key staff Nursing and Allied Health Support Services Kicked off officially 15 months ago and has detailed every system of care for our patients Brought together the collective know how and clinical expertise to define the future of care in three primary areas: 1) Physical plant construction 2) Team definition & skills 3) Resource depth & dynamics 6 Fosnocht Penn Presbyterian: Capacity to Care Penn’s strategy to focus on high intensity services is reflected in the highest Case Mix Index (CMI) scores both in the region and among our national competitors Top 15 Hospitals in the Philadelphia Region for Highest Medicare CMI UPHS Hospitals Compared to US News Honor Roll Hospitals (excludes specialty hospitals) HU P PPMC Te mple Je fferson Co oper Lo urdes Le high Valley La ncaster General Ha hnemann PAH La ncaster Regional St. Joseph - Reading Ei nstein La nkenau R e ading 0.0 Cleveland UCLA HUP Du ke UPMC Presby UCSF Brigham and Women's Mayo Clinic - Rochester Barnes Jewish PPMC Mass General NY Presby NYU Michigan Hopkins Northwestern P AH In diana Univ Mt Sinai 2.3709 2.0095 1.9046 1.8776 1.8704 1.7865 1.7803 1.7329 1.7316 1.7226 1.6298 1.6272 1.6245 1.6232 1.6217 0.5 1.0 1.5 2.0 2.5 2.5212 2.4010 2.3709 2.3148 2.1587 2.1270 2.1102 2.0620 2.0183 2.0095 1.9831 1.9819 1.9566 1.9204 1.8227 1.7944 1.7226 1.6784 1.5650 0.0 0.5 1.0 1.5 2.0 SOURCE: Centers for Medicare & Medicaid Services Case Mix Index, 2013, FFY13 IPPS Final Rule, based on data from FY2011 2.5 3.0 7 PPMC Outcomes Performance Number of Discharges for Acute Myocardial Infarction (MI) FY15) Number of Discharges for Congestive Heart Failure (CHF) FY15 PPMC performs “better than the national rate” in • 30-day Mortality for Congestive Heart Failure • 30-day Readmission Rates for Congestive Heart Failure • Catheter Associated Urinary Tract Infections PPMC ranks in the Top 10 of lower than expected mortality rates for Orthopaedics of the 114 university hospitals in the UHC database. 8 Resident and Student Training and PPMC Medicine • • • • • 4 General Medical Teams 1 Cardiac Care Unit Team 1 Geriatric Medical Team Chief Medical Resident Fellows in GI, Renal, ID, Cardiology Family Medicine and Community Health Surgery Orthopaedics OMFS Emergency Medicine Podiatry Pharmacy 9 Trauma Center at PPMC Construction Timeline Right Sized, Right Resourced: The new facilities are an exciting opportunity to modernize and expand capabilities across PPMC. http://www.uphs.upenn.edu/news/News_Releases/2013/05/groundbreaking/ FOR MORE INFORMATION- GROUND BREAKING VIDEO10 A Pavilion for the Trauma Patient Helipad Interventional Radiology (Wright Sauders) Trauma Med Surgery Beds (Cupp) Surgical Critical Care Perioperative Services Concourse and Café Radiology OR and Critical Care Pharmacy Emergency Department Trauma Resuscitation 11 1) Emergency Services Entrance Powelton Ave The new 5 floor Pavilion is designed around the care of the Trauma patient Rooftop helipad descends directly to Trauma Bay/OR/SICU New 20 Bed Trauma SICU connects directly to Trauma Floor Unit 5 – Trauma Bays are only a one floor assent to the OR Dedicated drive and parking for ambulance entrance to resuscitation bays separated from Emergency Department ambulatory side 12 2 ) The New Trauma Resuscitation Area Spacious 5-bay resuscitation area: the largest known design dedicated to trauma resuscitation - facilitates immediate access to “Corridor of Life” critical care treatment areas. Immediate adjacency to CT and MRI Ceiling mounted equipment and x-ray Elevators to OR and from Helipad Ambulance Entrance 13 3) All New PeriOperative Experience All new PACU and support spaces support optimum efficiency and flow to the OR New main hospital entrance welcomes patients and family members and serves as gateway to the Pavilion PACU PeriOp Support T 16 ORs Pre-OP 14 4) Surgical Critical Care & Patient Beds 4th Floor 20 Bed Surgical Critical Care Unit spanning 38th street with beautiful views of Center City skyline Collaborative, multidisciplinary workstations at each side of the unit Bridge connection to Trauma patient bed floor on Cupp 4 East Large conference space to facilitate interdisciplinary team activities All Private patient rooms in the Cupp 4 East med surg unit 15 PPMC Nursing Leadership Team James Ballinghoff MSN MBA RN Chief Nursing Officer Magnet Program Director Nursing Shared Governance Clinical Director of Trauma/Ortho Clinical Director, Emergency /Medical Nursing Clinical Director, Cardiology Nursing Director, Nursing Education & Research Clinical Director, PeriOp Nursing SICU/Trauma ED/Trauma CT/CCU Educators Main Operating Room SICU/Neuro MICU 3 East Cardiac Surgery 4 East/ Trauma 4 South General Med 3 South Cardiology PAT/SPU 5 East/Ortho ACE Geriatrics Occupational Medicine ENDO 5 South/Ortho Wright 5 Psych Nursing Admin Coordinators Observation Wright 4 Detox Core Councils Ambulatory Surgical Facility Scheie Operating Room PACU Nursing Resource Center IOP Leaders who previously transitioned from HUP 16 Professional Practice Models PPMC PROFESSIONAL PRACTICE MODEL: STAR Culture of Excellence SHARED GOVERNANCE HUP NURSING EXCELLENCE IN PROFESSIONAL PRACTICE MODEL LEADERSHIP ACCOUNTABILITY PATIENT FAMILY & COMMUNITY CARE DELIVERY SYSTEM MODIFIED PRIMARY NURSING PROFESSIONAL DEVELOPMENT & LIFE LONG LEARNING RESPECTFUL WORKPLACE INTELLECT OF INQUIRY 17 Critical Care Design – A Team Effort The critical care collaboration station - hub for multidisciplinary collaboration of physicians, nursing staff, critical care clinicians and support staff. The private, Critical Care Room in the new Pavilion is designed to facilitate and maximize both patient care and comfort • • • • • • Ceiling mounted utility booms, Maximum flexibility of the bed positioning based on care need Dedicated in suite space for patient family members In room storage for patient belongings Small work space in the room Natural light and healing layout 18 PPMC Recognized for Outstanding Performance Nursing Demographics Professional Nurses DCN Research Projects 690/FT 210/PT 8 Magnet designation 2012 DCN All RN Certification Rates 28.3% 30.6% BSN 77.0% 74.3% MSN/Phd 5.8% 8.9% BSN or Greater 82.8% 83.2% CNI = 7.4% Beacon awards for outstanding clinical care in PPMC critical care units MICU (2013), SICU (2010, 2013) & CCU (2010, 2013) CNII = CNIII = CNIV 58.2% 26.3% = 8.1% TJC Disease Specific Certification VAD, Knee/Hip, Primary Stroke US News and World Report Ranking 8th in Pennsylvania 4th in Philadelphia Metro Area Second year in a recognition row by the 2013 Truven Health Analytics “100 Top Hospitals”, as one of 15 Major Teaching Hospitals named in the top 100 nationally & 7 time selection as a “50 Top Cardiovascular Hospitals” 19 Trauma Transition – Human Resources Guiding Principles Goal: Create the employment proposition to assure HUP Trauma Team personnel successfully transition to PPMC Trauma Program and Services. Assure that PPMC personnel are fully engaged and embrace the Trauma Program. Phase I • Hold Employee Meetings (Nov 1 – 15) Phase II • Request employee preference (Nov 1 – Dec 15) Phase III • Employee Decision required (Jan 1 -15) Pre Launch • Communication to Employees advising of placement (Feb – Mar) 20 Trauma Transition – Human Resources Guiding Principles Support Penn Medicine Trauma Program at PPMC location brand which requires existing Trauma Team members relocation Assure Trauma Foundation requirement of transfer of clinical competencies for Faculty, Advanced Practice, Registered Nurses and critical Allied Health positions No need to apply for positions at PPMC location Mitigate any Human Resources differences as barriers to transfer to PPMC payroll Human Resources programs: UPHS seniority and tenure are based on original date of hire and transfer to PPMC 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 Registered Nurses will convert to Exempt/Professional model Allied Health job requirements will be standardized Department/unit specific programs will be finalized as part of planning process PPMC Nursing Leadership structure will be in place prior to requesting staff to commit. Need to answer the question of “Who is my Manager?” Allied Health staff will integrate into existing PPMC management structure HUP transition target: 150 FTE’s 21 Talent Transition Details: Process 1) Hold All Employee Meetings at HUP/PPMC – November 2) CNO, PPMC Nurse Leaders available to attend HUP Unit/Department staff meetings – November 3) PPMC Leadership, Department Directors, and Nurse Managers hold open-house for HUP clinical staff – December 4) HUP clinical staff communicate decision to relocate to PPMC to Manager and Human Resources – November-January 5) PPMC Leadership and Human Resources document specifics to each staff member relocating to PPMC – January-February 22 Talent Transition Details: Next Steps Communication site launched – Shaping Our Future site for HUP, CPUP, PPMC, and Faculty – November 15 Recruitment of key leadership roles in PPMC Nursing division Size education requirements for FY15 Budget Launch unit and department specific work teams Develop workforce education plan for existing staff (HUP & PPMC) and new hires Develop workforce recruitment plan for ASF and Trauma in four areas: NP’s, RN’s, Allied Health and Support Services 23 Trauma Center at Penn Presbyterian 24