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SAN FRANCISCO GENERAL HOSPITAL

SAN FRANCISCO GENERAL HOSPITAL. WELCOME Sue Carlisle, PhD, MD Vice Dean for UCSF at SFGH. San Francisco General Hospital & Trauma Center. SFGH Mission Statement: “ To provide quality healthcare and trauma services with compassion and respect.”. “We Save Lives”.

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SAN FRANCISCO GENERAL HOSPITAL

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  1. SAN FRANCISCO GENERAL HOSPITAL WELCOME Sue Carlisle, PhD, MD Vice Dean for UCSF at SFGH

  2. San Francisco General Hospital & Trauma Center

  3. SFGH Mission Statement:“ To provide quality healthcare and trauma services with compassion and respect.” “We Save Lives”

  4. SFGH is one of 19 public hospitals in CA • Today, just 6% of hospitals • Provide nearly half of the hospital care to the state’s uninsured • Operate almost 60% of CA’s trauma centers • Operate almost 45% of the burn centers • Serve 2.5 million patients per year • During the economic crisis, the need for services is growing

  5. SFGH Serves San Franciscans • Only Level 1 Trauma Center in San Francisco • Only Psychiatric Emergency Service • Largest Acute & Rehabilitation Hospital for Psychiatric Patients • General community hospital and ambulatory care services for San Francisco’s under- and uninsured • Referral Center for DPH and its affiliated partners • Provides 20% of all inpatient care in San Francisco

  6. SFGH DIVERSITY OF PATIENTS> 100,000 individuals Age Sex Race

  7. Payor SourcesFY 2010-2011

  8. Top 10 Discharge Diagnoses FY 2011-2012 • Normal Delivery • Psychosis • Congestive Heart Failure • Chronic Paranoid/Schizophrenia/ • Pneumonia • Alcohol Withdrawal • Obstructive Chronic Bronchitis • Septicemia • Leg Cellulitis • HIV Disease

  9. SFGH ValuesFY 2011 - 2012 • Patient and staff safety • Quality healthcare • Disease prevention • Staff retention and recruitment • Culturally responsive care • Efficient resource management • Academic excellence in training and research

  10. SFGH Goals FY 2011-2012 • Service Excellence • Clinical Quality and Health Equity • Professional and Academic Excellence • Safety and Accountability • Enhance wellness • Efficient Management System • Integration and Coordination Across Services • Develop and Expand Information Technology • Moving Beyond “Implementation” towards “Adoption” of HIT

  11. SFGH FACTS:FY 2011-12 • $772 Million Total Budget • 108,000 Unduplicated Patients • 520,000 Outpatient Visits • Licensed Beds: • 403 General Acute Care • 106 Acute Psychiatric • 59 Skilled Nursing Mental Health • 30 Skilled Nursing Med/Surg

  12. SFGH FACTS:FY 2011-12 • 15,992 Admissions • 10 Operating Rooms • 6,800 procedures • 20% are emergency • Operate @ 90% capacity (industry standard is 80%)

  13. Baby Friendly Hospital • SFGH named by World Health Organization as Baby Friendly in May 2007 • Only Baby Friendly hospital in San Francisco • 1 of 154 hospitals in U.S. • 1,220 babies were born at SFGH • Over 3,000 women received prenatal care, 30% high-risk

  14. Trauma and EmergencyFY 2011-12 • Over 55,000 Emergency Room visits – 18% are admitted • Over 6,000 Psychiatric Emergency encounters - 25% are admitted • Receives 30% of all ambulance traffic in San Francisco • 3,300 adults and children are treated for injuries requiring the trauma activation.

  15. Stroke Center • SFGH Stroke Program was started in 1996 • JCAHO certified as a Stroke Center in 2007 • Recertified as a Stroke Center May 2009 and July 2011 • SFGH as site of CASPR (California Acute Stroke Prototype Registry) • Stroke Pager: 443-NERV (6378)

  16. Multicultural stroke population reflective of SF

  17. Emergency Department

  18. SFGH-UCSF AFFILIATION SFGH has partnered with UCSF for over 140 years through our teaching, research and clinical affiliation 1959: First Formal Affiliation • $174,000 for clinical services • 10 full time faculty 1994: Renegotiation of Affiliation Agreement • $46 million • 237 active medical staff (All UCSF Faculty) • 1200 UC employees

  19. SFGH-UCSFAFFILIATION 2011-2012: • 500 UCSF faculty on active medical staff • Approximately 2500 UCSF faculty and staff • Total amount of contract - $129,689,089 • Physician Services • Clinical Laboratories • Respiratory Therapy • Biomedical Engineering

  20. Clinical Training School of Medicine • 32% intern/resident training in 18 academic departments • 35% medical student clinical training • On average, 900 residents, 350 medical students and 60 clinical fellows annually • Includes training requirements not available at other UCSF sites • Several training programs based at SFGH

  21. Clinical Training School of Dentistry • Oral surgery: 5,079 clinical encounters/year • Residency: 4 residents/day • Dental students: 4 students/day

  22. Clinical Training School of Pharmacy • Poison Control Center • Average 5 students/day at SFGH • Average 3 residents/day at SFGH

  23. Clinical Training School of Nursing • Average of 50 nurse practitioner students/year • 65 masters students do SFGH rotation each spring • 16 graduate nursing students/day

  24. Research at SFGHCurrent Situation • Dedicated research and academic space • 249, 962 ASF • Grants awarded to PIs at SFGH in 2011-2012: • $167M total • Number of PIs –200 • Average 80 research fellows and 5 graduate students per day

  25. Research and Training at SFGH • Our mission is to provide excellent clinical care for residents of San Francisco while teaching UCSF students/residents. • An academic environment is essential to attracting (retaining/recruiting) an excellent faculty to provide this care and teaching. • Research is an essential component of an academic environment. • Thus, research is essential to the mission of UCSF at SFGH and of the hospital itself.

  26. ChallengesReplacement of Research Space • Majority of the research is now located in 1916 “red brick buildings” • UC Office of the President regulations require that we vacate these buildings by 2015 for seismic reasons • Academic Planning Committee recently evaluated future needs and recommended replacement of outdated labs and expansion of research space • Currently negotiating with City for land to build state of the art research facility at SFGH

  27. ChallengesRebuild of Hospital • SB 1953 requires all CA hospitals meet new seismic standards • General obligation bond ($887.4 M) passed in November (84% approval) • Initial construction is underway • Will impact parking availability • Will generate moves, dust, noise • Completion expected by 1/2015

  28. California Assembly Bill 211 (AB-211)January 2009 • AB 211 provides fines and civil penalties against any individual who negligently discloses or knowingly and willfully obtains, discloses, or uses medical information in violation of state / federal laws. • Enforced by Office of Health Information Integrity (CalOHii) • Penalties various fines per violation, one of which has a maximum of US$250,000 • misdemeanor if the patient suffers economic loss or personal injury • potential for civil action by the patient with statutory damages ($1,000) in addition to actual damages • notify the licensing board for further investigation or discipline of individual providers • May apply to institutions or to individuals or to both

  29. California Senate Bill 541 (SB 541)January 2009 • SB 541 imposes penalties upon institutions failure to prevent or report for unauthorized access use, or disclosure of medical information. • Enforced by Calif. Department of Public Health (CDPH). • Penalties: • up to US$25,000 per patient • up to $17,500 per subsequent access, use, or disclosure • $100 per day that the violation is not reported within the 5-day reporting period • Applies to institutions, not to individuals.

  30. SFGH Orientation Material • Prior to doing their initial rotation at SFGH, all new residents or fellows must review the SFGH Orientation material. • The material is posted on both the GME and the SFGH Dean’s Office web pages, entitled “SFGH Orientation Handbook.” • http://sfgh.ucsf.edu/quick-links-sfgh-faculty-staff-residents • For purposes of documentation, residents are to send an email to their program and site coordinators stating that they have completed a review of the hospital’s orientation material. We hope to automate this latter procedure in the near future.

  31. SFGH Scrubs PolicyForest Green Scrubs must not leave the SFGH campus! • Do not cross any streets while wearing scrubs— no lunches, no Walgreens, no shuttle, no Parnassus, no bike rides, no driving to/from work! • Please use the scrub machines on the Ground Floor to obtain scrubs (see your department administrator to get access). • Forest Green Scrubs are hygienic and must be laundered by SFGH. • Residents and students will only be able to obtain their hygienic scrubs via the scrub machines located on the G level of the hospital. They will not be available in the OR areas.

  32. The Heart of the City

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