Penn Presbyterian Transformation The Next Chapter…What It Means To You March 2014 PPMC Special All Employee Meetings

2 The Journey Has Begun! - Occupying two gorgeous new buildings on the campus - Welcoming trauma patients through our as the Level 1 Trauma Center at Penn - Performing Neurosurgical and Orthopedic Trauma cases on the campus - Launching EPIC in our radiology and ED departments One year from now: - Watching the campus and skyline of PPMC change daily - Days away from the ribbon cutting of the newly renovated Scheie Eye Institute - Fine tuning the plans, people, and process needed in the months ahead Today: - Preparing for groundbreaking of the Pavilion for Advanced Care - Laying the foundations for the now 13-story Penn Medicine University City - Defining the resources & skills, and talent staff needed in 2015 One year ago :

3 Our Pavilion for Advanced Care and Penn Medicine University City are transformative structures for Penn Medicine as well as the revitalization of 38 th Street.

4 March Construction Update June ‘13 August ‘13 October ‘13 January ‘14 Penn Medicine University City

5 March Construction Update  Steel Topped out – Feb 28 th  Exterior skin started  Stud framing and mechanical, Electrical and plumbing started Pavilion for Advanced Care

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7 First Patient Schedule – August 2014 Retail Pharmacy, Lobby, Security GSPP Physical Therapy and Offices CPD/Support/ Materials The Surgery Center at Penn Presbyterian MSK Radiology Reading Rooms Allergy & Immunology Clinic & Offices Otorhinolaryngology Clinic and Offices Surgery and Urology Clinic Medical Imaging & Diagnostic Services Radiology (X-ray) Orthopaedic offices only Ortho Spine & Hand Clinic Ortho Trauma (HUP) Clinic Ortho Shoulder & Joints Clinic Rheumatology ClinicNeurosciences Clinic Remaining offices (MSK Radiology & PPMC Rheumatology) Board Room 3,200 OP surgical cases shift from PPMC to new Surgery Center & GSPP closes therapy site at 3624 Market A&I from Mutch 6 Oto from MOB 3 Surgery from W/S 2 Urology from MOB 2 Mammography from W/S 3 Pleural Program Practices close & move: Ortho from Cupp 1 and HUP Silverstein Rheum from 3910 Neurology from MOB 3 Practices close and move: MSK Radiology from PCAM Ground New duplicative Services established : MRI, X-ray, EEG, registration, EKG Ultrasound, Vascular Lab, Phlebotomy, Outpatient Pharmacy 8/4 8/11 8/24 9/8

8 PPMC Campus Impact of Opening The opening of Penn Medicine University City is projected to shift from the main Presbyterian campus:  68,000 annual outpatient clinical practice visits  All PPMC Mammography and Dexascan screenings  3,200 outpatient surgical cases  A portion of… outpatient medical imaging (x-ray, ultrasound, MRI) non-invasive vascular lab, EKG, EEG, outpatient phlebotomy, outpatient pharmacy  64 faculty – from orthopedics, neurology, allergy & immunology, otorhinolaryngology, surgery, urology, rheumatology & neurosurgery  192 staff – including 40+ new hires in the hospital based areas  Patient parking tied to the above noted visits

9 New Programs Accommodated Via Moves New /Expanded Program PlansSpaceOpening Third Interventional Radiology LabW/S 4July 2014 Pathology central receiving & Blood bank renovationsW/S 5December 2014 CPUP Neurosciences faculty offices for neurosurgery, neurocritical care, and neurology TBDDec 2014 Penn Trauma program staff, advanced practitioner and faculty offices from HUP MOB 1Dec 2014 Call Room suite for trauma and sub-specialistsW/S 4Jan 2015 Combined faculty offices for the Department of Surgery with Urology Division W/S 2Dec 2015 Acute Care Research collaborative program research space Mutch 3TBD Space Closures/ No BackfillSpace PPMC Rheumatology3910 Vacated space due to University City moves allows for new and expanded programs on the main campus..

10 Campus Renovations Underway MRI Suite Davita dialysis relocated in January to make way for the 2 room – MRI suite ED Rapid Triage Intake ED registration and part of the lobby and entrances are under renovation OR 16 The MRI has moved to a temporary trailer in Myrin Circle to make way for the construction of the concourse and OR16 on the 2 nd floor Complete July/August 2014 Complete July 2014 Complete December 2014

11 Pavilion for Advanced Care Occupancy Perioperative Services OR and Critical Care Pharmacy Prep/Recovery & PACU Surgical Critical Care Trauma Resuscitation Emergency Department Cupp 1 Medical Imaging Heart and Vascular Critical Care New construction completion anticipated November 17, 2014 allowing for equipment, furniture, IT, stocking and staff training and licensure activity Patient Occupancy: SICU (4 th ) January 4 HVICU (3 rd ) January 4 PeriOP (2 nd ) January 10 ED expansion (1 st )January 12 CT (1 st ) (2 units)January 12 Trauma Unit (training)January 6

12 Trauma Center at Penn Presbyterian PPM FEBRUARY 4, 2015 We have set a date to move the Level 1 Trauma Center

13 Penn Presbyterian Transformation  In addition to the unit transitions to occupy the new Pavilion for Advanced Care several internal main campus units and patient population moves will also occur.  Allows for service line consolidations and co-location of the general acute care population on the campus  Enables staffing & resources as a “full capacity organization” Licensed Beds Ave. Daily Census Occupancy Admissions Surgeries ED visits 305 Acute Care, 26 SNF+26 Acute Beds Acute 197, SNF 17, Total : ADC 72.9% 79% Occupancy 15, Admissions 13, Surgeries 39, ED/Trauma Visits TODAY2015

14 Current StateNext Chapter 5 EastOrthopedics, General Med/SurgOrthopedics, Ortho Trauma, Neuro/Gen Surgery 5 SouthOrthopedics, General Med/SurgOrthopedics, Ortho Trauma, Neuro/Gen Surgery 4 EastThoracic, Stroke, General Med, and Observation General Care Trauma Unit 4 SouthMedical 3 EastCardiac SurgicalCardiac Medical/Surgical 3 SouthCardiac Medical, Heart Failure/Pulmonary Hypertension Heart Failure, Thoracic, Stroke MICUMedicalOR Locker Room/Office Space SICUGeneral Surgery, Orthopedics, CT & Vascular Surgery MICU CCUCardiac Critical Care Patients/Heart Rescue Observation Unit Penn Presbyterian Internal Transitions

15 Current StateNext Chapter ED PAC 1 20 patient rooms plus overflow 33 ED beds, plus 2 ED resuscitation & 5 Trauma resuscitation bays & 5 Rapid Triage Area rooms PACU/SPU PAC 2 Separate UnitsCombined Unit/Prep & Recovery - Improved Patient Flow Patient Experience PAC 3Heart & Vascular Intensive Care Unit PAC 4General Surgery, Neuro Surgery, &Trauma Intensive Care Unit PAC 5Neuro Surgical Intensive Care Unit (FY16) Penn Presbyterian Internal Transitions

16 New Building Orientation Orientation & TrainingClassroom Instruction 5 EastXX 5 SouthXX 4 EastX 3 EastXX 3 SouthXX MICUXX EndoXX ResourceXX PAC 1XXX PAC 2XX PAC 3XX PAC 4XXX ASFXX Total Education Expenses Exceeding 1.8 Million Preparing Teams for the Transitions

17 James Ballinghoff MSN MBA RN Chief Nursing Officer Magnet Program Director Nursing Shared Governanc e Clinical Director of Trauma & Orthopedics PAC 4 SICU/Trauma PAC 5 SICU/Neuro 4 East/ Trauma 5 East/Ortho 5 South/Ortho Occupational Medicine Clinical Director, Emergency & Medical Nursing ED/Trauma MICU 4 South General Med ACE Geriatrics Wright 5 Psych Wright 4 Detox IOP Clinical Director, Heart & Vascular Nursing PAC 3 Heart & Vascular Intensive Care Unit 3 East Cardiology Med/Surg 3 South Heart Failure, Thoracic Observation W/S 3 Nursing Admin Coordinators Nursing Resource Center Director, Nursing Education & Research Educators Core Councils Clinical Director, PeriOp Nursing Main Operating Room Scheie Operating Room PAC 2 SPU/PACU ENDO Ambulatory Surgical Facility PPMC Nursing Leadership Team

18 New Unit and Team Transitions  We are anticipating 200 FTEs from HUP to transition to PPMC for February 2015 start dates  72% of the transitioning staff are in the Department of Nursing  All teams will experience a blending of staff, some more than others  Team structure and blending will take into account the following criteria such as competency to serve the patient population, Penn Medicine seniority and compliment of current shift schedules  After the FY15 budgets are finalized in April we will know volume allocations and can provide firm details on unit staffing -- WE NEED YOU – PLEASE GIVE US AN OPPORTUNITY TO PROPOSE OUR PLANS WITH FIRM DETAIL

19 Transitions Timing and Education Apr. MayJuneJulyAug. Mar. Define areas at All employee meeting Group Interviews led by CMO/CNO pairs Oct.Sept.Nov.Dec.Jan.Feb. Education for Staff RN Professional Exempt model begins Shift Diff Changes implemented 1 st Trauma patient seen at PPMC PAC building is turned over SICU to 4 PAC CCU to 3 PAC Obs. To Cupp 3 SPU/PACU To PAC 2 ED exp. to PAC 1 MICU to 2 Myrin 4 East Trauma Penn Medicine University City opens PeriOp, hospital operations and CPUP staff move Staffing plans finalized

20 Transition Details - Human Resources  HUP staff have committed to transition to PPMC by signed letter  Mitigate any Human Resources differences between entities as barriers to transfer and retention to PPMC payroll and internal transfers as a result of our transition  Working to ensure a smooth integration of combined PPMC teams and new job roles  New hires are anticipated for both buildings and positions will be posted  Human Resources programs in development:  Base Pay Compensation program will be the same  Benefits program is the same including Tuition and Paid Time Off programs  Shift Differential policy and rates will be equal  Certification and Preceptor bonus pay will be standardized  Registered Nurses will convert to Exempt/Professional model  Allied Health job requirements will be standardized

21 The Next Round of Details We anticipate a 3 rd round of All Employee Meetings to take place in mid-summer Topics for that session will explore in greater detail the plans for  Human resource program details and timing  Parking plan details  Campus security after the Trauma move  Transportation between HUP & PPMC  Traffic and pedestrian plans around campus