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 FloorDepartment 8Penn Neurosciences Clinic (Neurology & Neurosurgery) Penn Musculoskeletal Center (Orthopaedics & Rheumatology) 7Medical Imaging, Outpatient Lab & EKG, Neurodiagnostic Lab & Non-Invasive Vascular Lab) Penn Musculoskeletal Center ( Orthopaedics, Pain Medicine; Sports Medicine ) 6Administrative Offices & Faculty Offices 5The Surgery Center at Penn Medicine University City 4Surgery & Urology Penn Mesothelioma & Pleural Program 3Allergy & Immunology Endocrinology, Diabetes & Metabolism Otorhinolaryngology 2Penn Therapy & Fitness Physical Therapy 1Retail Pharmacy Note: Floors 9 and 10 will be occupied in the spring of 2015

5 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

6 Safety Enhancement - Crosswalk 38 th 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 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 3

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 40 th & Walnut  Currently parking rate for the 40 th & 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 4 East - Trauma Bed Unit Renovations In preparation as the Trauma Med Surg Bed Unit the following renovations are taking place beginning in September 2014 through November 2015 on Cupp 4 East:  Patient lift installations  Resident work room construction  Staff locker reconfiguration  Family waiting room construction  Secured unit card and camera installations  4 Wright Saunders Gym  Patient room additions (2)  Cosmetic renovations

11 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

12 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

13 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

14 Human Resources Programs

15 Transition Guide  PPMC ID badge  Parking coordination  Campus orientation  Department orientation  Uniform  Team integration and development  Manager introductions  Employee file transfers  AU and payroll transition  Personal space/office item moves Staff and faculty transitioning will be provided with a coordinated guide to assist in the welcome to the PPMC campus in the upcoming months.

Campus Transition Timelines Aug Fall Dec

Campus Transition Timelines 01/05/15 01/10/15 01/12/15 01/19/ /26/ /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: Pregnant Patients Neonatal and Pediatric 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 PTSF Survey Cycle DateEvent November 4, 2014Survey (EAFS) Application Due (Inc documentation reflecting % of nursing and physician staff transitioning and demonstration of their trauma education and competency) November 14, 2014Questions on survey from PTSF to HUP December 3, 2014Question responses from HUP to PTSF Early DecemberPTSF update to PTSF Board regarding areas of non compliance which may require action plan December 11Medical Record pull discussion with Policy and Procedure Committee February 4, 2015Move April 3, 2015Survey (EAFS) due from PPMC April , 2015Tentative MOCK survey site review April 24, 2015Questions due from PTSF to PPMC May 8, 2015Question response from PPMC to PTSF June 24, 2015Site survey PPMC : 4 Team membe

25 HUP after February 4 th Trauma Move  02/04/15 effective midnight Level I Trauma Center program and designation will transfer to PPMC.  HUP will no longer be an accredited trauma hospital  Ground and Flight ambulances must transport major trauma patients (patients with severe injury that threatens life and limb) to a level I or II trauma hospital within 30 minutes transport time  These EMS and Police/Fire Rescue transported trauma patients will be taken to PPMC.  Today over 200 trauma patients arrive to HUP by “private vehicle or walk in” - the message to these patients that the formal Level I Center has moved will take time to redirect…

26 HUP Emergency Surgical Services Capacity As a major academic medical center HUP will continue to have the resources to provide multidisciplinary treatment and specialized resources for emergent and injured patients.  HUP retains ability to mobilize in-house resources to treat or transfer a severely injured patient that requires emergent treatment / management of all surgical emergencies efficiently

27 Ask the Audience…  Please get out your phone  Open your messaging app  Create a new text to: