Mission Bay Operations Planning Update for Clinical Affairs Committee June 22, 2011

High Level Timeline

UCSF Medical Center at Mission Bay Project and Operations Planning: DRAFT Clinical Enterprise Governance (CEG) Mission Bay Steering Committee Executive Sponsor, Operations Planning Ken Jones, COO Mission Bay Hospitals Project Cindy Lima, Executive Director Faculty/Physician Subcommittee Elena Gates MD Scott Soifer MD Mark Laret CEO MB IT Steering Committee TBD MB Finance Committee Barrie Strickland Spencer Kowal Operational Planning Kim Scurr, Director  Operational Readiness  Process flows  New operations/programs  Process implementation, process redesign, work streams  Staffing requirements, Medical model  MB budget needs  Transition/move planning

Role and Responsibilities – Physician Work Group Leaders Role and Responsibilities  Leads/drive project activities for their respective operational areas to ensure that patient clinical needs are addressed and services are fully coordinated  Focuses on physician operations design, process improvement, process integration with a goal of best practices – will require working with own operational areas and other departments  Identifies performance metrics  Provides subject matter expertise for their respective area  Manages project resources for their respective groups  Works with project manager to create work plan  Ensures that activities are completed in a timely manner  Identifies and resolves issues – including identification of options by working with team members and across functional groups or services as appropriate  Coordinates and executes implementation activities with other groups as needed  Identifies potential areas of risk and recommends appropriate intervention steps  Works with project manager to communicate project status to project management  Evaluates project deliverables as needed  Identifies Mission Bay staffing and other resource needs (e.g., budget, equipment, technology) for operations and transition planning, actual move, and 2015 operations at Mission Bay Issues Addressed  Physician care delivery and processes  Physician operational readiness  Physician staffing model  Transition planning 4 DRAFT

Key Design Work for Physician’s Group Visioning –Vision/Guiding Principles - Review and confirm suggestions for vision and guiding principles Strategies for Care Delivery –Emergency Department - new department at UCSF; Children's ED + adult coverage High-Risk OB Services- Need to maintain UCSF hallmark safety and quality of care including quick access to all adult specialists for a variety of specialized conditions (e.g., intracranial bleeding, organ failure, complex hematologic or autoimmune conditions). There are impacts to the NICU. –Need to provide access to specialty consults –Need to identify MB to Parnassus transfer protocols –Need to identify process and facilities for providing OB care at Parnassus after the move

Key Design Work for Physician’s Group Right care for the right patients and Pedi/Adult and Consults - Relationship between adult and pediatric specialties at Mission Bay and the role of pediatric specialists in adult care, cancer and OB/GYN, and of adult specialists in the care of pediatric patients. Questions: –Is a pediatric specialist appropriate for adult cancer patients, OB patients, and gynecology patients? –Are hospitalists the source of adult inpatient coverage? –How will specialist consults be covered at MB? On call? Paid for by whom? Leased by medical center? –Who provides clinical coverage in the ED and after hours imaging for pediatrics and adults? –SFGH Faculty - Could they be used for consults? –Who provides in-house anesthesia coverage after hours?"

Key Design Work for Physician’s Group Pediatric Services provided by Adult Departments - Ortho, Neuro, ENT, Transplant. Will Adult providers continue to provide coverage nights and weekends? Adult cancer - Outpatient cancer clinics at Mount Zion with cancer surgery at Mission Bay; difficult logistics for surgeons. Initiate planning of adult outpatient building?- Identical issues for GYN Adult ICU - Managed by which department? Primary team? Need OB intensivist? New model of care delivery - given private and double rooms (ICNs) and increased geography, determine medical delivery model for Mission Bay Telemedicine/Central Monitoring – What is the role of telemedicine? Ambulatory care - determine model of care and business model. Identify any differences between children and adult ambulatory care

MB PMO Future Staffing