Penn Presbyterian & Trauma Transitions

1. Penn Presbyterian & Trauma Transitions September 2014 Special All Employee Meetings

2. 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

3. 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:

4. Penn Medicine University City Occupants Note: Floors 9 and 10 will be occupied in the spring of 2015

5. 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 • 2 (1.5T MRI) & control room • Inpatient holding • Prep consult space • Radiologist reading room • Male & Female changing

6. 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

7. Security Enhancements

8. Staff Parking at PPMC 1 • Penn Presbyterian Campus Parking is located currently in five locations: • Powelton Lot • Scheie/3910 Lot • Rudolphy Lot • Main Parking Deck • Fresh Grocer Parking • Free Employee Parking: • In after 2 PM & out by 9AM • All Weekend • Main Parking Deck • Must have PPMC ID badge 3 2 4 5

9. 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

10. 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

11. 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 * Includes 20 advanced practice providers

12. 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

13. Human Resources Programs

14. Transition to RN Professional Exempt Model Professional Nurse: Pay Program • UPHS supports the professionalism of RNs while remaining market competitive in pay and practices. • Penn Medicine Nurses are full partners with Physicians and other health care professionals. HUP RN’s have been classified as exempt under the Fair Labor Standards Act for over 20 years, setting the model for the rest of the country. • Nurses will be scheduled over a two week (80 hour) period allowing flexibility in scheduling to fulfill their guaranteed FTE. To recognize Nurses who work beyond 80 hours in a pay period, a premium pay will be paid for time worked in excess of 80 hours. This premium pay is equal to 1.5 times the Nurse’s base rate of pay. • To give the professional Nurse flexibility and discretion during their time at work, time worked that is less than 30 minutes before or after the nurse’s scheduled shift does not qualify for premium pay. When time worked exceeds 30 minutes before and/or after the scheduled shift, then all the time worked before and/or after the shift may qualify for premium pay. Qualifying minutes are not cumulative in the same day, or from day-to-day.

15. Alignment of Shift Differential Practices • Scope: all shift differential eligible positions at PPMC to adopt UPHS shift differential practices (same as HUP’s current practices) • Summary of current and proposed shift differential practices • Most significant changes: • All shift differential pay changes from a flat dollar amount to percent of pay • Those positions that move to a 12-hour pay rule will no longer receive any differential on 12-hour day shifts (7A to 7:30P) & will receive all night differential on 12-hour night shifts (7P to 7:30A)

16. 2014 Campus Transition Timelines Aug Fall Fall Fall Fall Dec Dec

17. 2015 Campus Transition Timelines 01/05/15 01/10/15 01/12/15 01/19/154 01/26/155 01/29/15 02/04/15

18. 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

19. 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

20. 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

21. “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: Neonatal and Pediatric Patients Pregnant Patients Inter-facility Transport

22. 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

23. Scenario Simulations Patient simulation scenarios will assist teams to practice many of the new clinical situations that the PPMC campus will encounter.

24. 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