Penn Presbyterian & Trauma Transitions

September 2014Special All Employee Meetings

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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:

360 staff and

faculty

140 Therapy

Visits

300

Clinic Visits

122

Medical Imaging

Visits

19 Surgery Cases

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Penn Medicine University City OccupantsFloor Department

8 • Penn Neurosciences Clinic (Neurology & Neurosurgery)• Penn Musculoskeletal Center (Orthopaedics & Rheumatology)

7 • Medical Imaging, Outpatient Lab & EKG, Neurodiagnostic Lab & Non-Invasive Vascular Lab)

• Penn Musculoskeletal Center ( Orthopaedics, Pain Medicine; Sports Medicine )

6 • 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

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First Renovations at PPMC opening

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

• (4) Test & Evaluation Rooms• Bereavement Room• Reopen side entrance to the

ED (former ambulance entrance) for all traffic

Half of the Emergency Department Renovations for the new Reception and Triage area have opened along with the new MRI suite

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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

• 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

Team

• Handcuff and baton carrying• Aggression management• Act 235 certification for enhanced control of situations• Crowd control methods

Skills

• 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

Facility

• 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 Response

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Staff Parking at PPMC

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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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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

Trauma Transition Guiding Principles

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Hospital Staff Impact FY15

HUP Nursing Transfers 156 FTE

HUP Non-Nursing Transfers53 FTE

99* FTEPPMC Non-Nursing Recruitment

328 Staff Impact

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

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CPUP Incremental Expansions for FY15

TOTALS• 14.1 FTE Faculty 7.0

Residents/FellowsAnesthesia Critical Care •5.1 Faculty 1.0 Critical Care Fellow

Emergency Medicine •3.0 Faculty 1.0 Resident

Medicine – Infectious Disease • 1.0 Fellow

Neonatology •Additional call

Neurosurgery •0.5 Faculty

Neurology-Neurocritical Care •1.0 Faculty 1.0 Fellow

Obstetrics •Additional call 1.0 Resident

Otorhinolaryngology • 1.0 Resident

PM&R •1.0 Faculty

Radiology – Interventional Rad. •1.0 Faculty & additional call

Surgery •2.5 Faculty 1.0 Critical Care Fellow

Department Faculty/Residents/Fellows

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

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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 to RN Professional Exempt ModelProfessional 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.

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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)

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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

2 new 1.5 T MRI suite at PPMC - Temporary MRI trailer closes

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

Aug

Fall

Fall

Fall

Fall

Dec

Dec

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2015 Campus Transition Timelines

SICU moves to new home in 4 PAC Trauma Surgical Critical Care Unit

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

01/05/15

01/10/15

01/12/15

01/19/154

01/26/155

01/29/15

02/04/15

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PPMC Service Enhancements

New welcoming Cupp lobby and Concourse

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

Many of the service and facility enhancements on the horizon enhance the patient care experience for ALL of the PPMC patients and providers

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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

Patient transport & Bed Flow

Pediatric trauma patient/ neonate pediatric patient

Family management in

Trauma Bay

Blood transport and order

Trauma impact to OR cases

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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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