penn presbyterian & trauma transitions
DESCRIPTION
Penn Presbyterian & Trauma Transitions. September 2014 Special All Employee Meetings. Today’s Session Highlights. Penn Medicine University City Campus Security & Parking H uman R esources plans Patient care unit changes timelines Service and support changes - PowerPoint PPT PresentationTRANSCRIPT
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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…
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