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SAN FRANCISCO GENERAL HOSPITAL. WELCOME Sue Carlisle, PhD, MD Associate Dean for UCSF at SFGH. San Francisco General Hospital & Trauma Center. SFGH Mission Statement: “ To provide quality healthcare and trauma services with compassion and respect.”. “We Save Lives”.

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San francisco general hospital

SAN FRANCISCO GENERAL HOSPITAL

WELCOME

Sue Carlisle, PhD, MD

Associate Dean for UCSF at SFGH


San francisco general hospital trauma center

San Francisco General Hospital & Trauma Center


San francisco general hospital

SFGH Mission Statement:“ To provide quality healthcare and trauma services with compassion and respect.”

“We Save Lives”


San francisco general hospital

  • SFGH is one of 19 public hospitals in CA

  • Today, just 6% of hospitals

    • Provide nearly half of the hospital care to the state’s uninsured

    • Operate almost 60% of CA’s trauma centers

    • Operate almost 45% of the burn centers

    • Serve 2.5 million patients per year

  • During the economic crisis, the need for services is growing


Sfgh serves san franciscans

SFGH Serves San Franciscans

  • Only Level 1 Trauma Center in San Francisco

  • Only Psychiatric Emergency Service

  • Largest Acute & Rehabilitation Hospital for Psychiatric Patients

  • General community hospital and ambulatory care services for San Francisco’s under- and uninsured

  • Referral Center for DPH and its affiliated partners

  • Provides 20% of all inpatient care in San Francisco


Sfgh diversity of patients fy 2008 2009 n 98 698

SFGH DIVERSITY OF PATIENTSFY 2008-2009 N=98,698

Age

Sex

Race


Payor sources fy 2008 2009

Payor SourcesFY 2008-2009


Top 10 discharge diagnoses fy 2008 2009

Top 10 Discharge Diagnoses FY 2008-2009

  • SCHIZOPHERNIA

  • NEWBORN DELIVERY

  • PNEUMONIA

  • CONGESTIVE HEART FAILURE

  • CHEST PAIN

  • ALCOHOL WITHDRAWAL

  • LEG CELLULITIS

  • SHORTNESS OF BREATH

  • HIV DISEASE

  • OBSTRUCTIVE CHRONIC BRONCHITIS


Sfgh values fy 2008 2009

SFGH ValuesFY 2008 - 2009

  • Patient and staff safety

  • Quality healthcare

  • Disease prevention

  • Staff retention and recruitment

  • Culturally responsive care

  • Efficient resource management

  • Academic excellence in training and research


Sfgh goals fy 2008 2009

SFGH Goals FY 2008-2009

  • Promote patient safety

  • Enhance clinical care

  • Promote staff retention & recruitment

  • Maintain hospital infrastructure

  • Comply with all regulatory standards & attain specialty certifications

  • Maintain services during hospital rebuild


Sfgh facts fy 2008 09

SFGH FACTS:FY 2008-09

  • $670 Million Total Budget

  • 100,000 Unduplicated Patients

  • 600,000 Outpatient Visits

  • Licensed Beds:

    • 403 General Acute Care

    • 106 Acute Psychiatric

    • 59 Skilled Nursing Mental Health

    • 30 Skilled Nursing Med/Surg


Sfgh facts fy 2008 091

SFGH FACTS:FY 2008-09

  • 16,031 Admissions

  • 10 Operating Rooms

    • 6,695 procedures

    • 48% are emergency

    • 1,118,100 surgical minutes


Baby friendly hospital

Baby Friendly Hospital

  • SFGH named by World Health Organization as Baby Friendly in May 2007

  • Only Baby Friendly hospital in San Francisco

  • 1 of 63 hospitals in U.S.

  • 1,340 babies were born at SFGH

  • 1,1470 women received prenatal care, 25% high-risk


Trauma and emergency fy 2008 09

Trauma and EmergencyFY 2008-09

  • Over 53,000 Emergency Room visits – 15% are admitted

  • Over 7,200 Psychiatric Emergency encounters - 26% are admitted

  • Receives 30% of all ambulance traffic in San Francisco

  • 3,500 adults and children are treated for injuries requiring the trauma activation.


Stroke center

Stroke Center

  • SFGH Stroke Program was started in 1996

  • JCAHO certified as a Stroke Center in 2007

  • Recertified as a Stroke Center May 2009

  • SFGH as site of CASPR (California Acute Stroke Prototype Registry)

  • Stroke Pager: 443-NERV (6378)


Multicultural stroke population reflective of sf

Multicultural stroke population reflective of SF


Emergency department

Emergency Department


Sfgh ucsf affiliation

SFGH-UCSF AFFILIATION

SFGH has partnered with UCSF for over 130 years through our teaching, research and clinical affiliation

1959: First Formal Affiliation

  • $174,000 for clinical services

  • 10 full time faculty

    1994: Renegotiation of Affiliation Agreement

  • $46 million

  • 237 active medical staff (All UCSF Faculty)

  • 1200 UC employees


Sfgh ucsf affiliation1

SFGH-UCSFAFFILIATION

2008-2009:

  • 480 UCSF faculty on active medical staff

  • Approximately 2500 UCSF faculty and staff

  • Total amount of contract - $95,231,732

    • Physician Services

    • Clinical Laboratories

    • Respiratory Therapy

    • Biomedical Engineering


Clinical training school of medicine

Clinical Training School of Medicine

  • 32% intern/resident training in 18 academic departments

  • 35% medical student clinical training

  • On average, 238 residents, 75 medical students and 42 clinical fellows per day

  • Includes training requirements not available at other UCSF sites

  • Several training programs based at SFGH


Clinical training school of dentistry

Clinical Training School of Dentistry

  • Oral surgery: 6600 clinical encounters/year

  • Residency: 4 residents/day

  • Dental students: 16 students/day


Clinical training school of pharmacy

Clinical Training School of Pharmacy

  • Poison Control Center

  • Average 5 students/day at SFGH

  • Average 3 residents/day at SFGH


Clinical training school of nursing

Clinical Training School of Nursing

  • Average of 26 nurse practitioner students/year

  • 15 masters students do SFGH rotation each spring

  • 5-40 graduate nursing students/day


Research at sfgh current situation

Research at SFGHCurrent Situation

  • Dedicated research and academic space

    • 248,495 ASF

  • Grants awarded to PIs at SFGH as of 7/09:

    • $450 M total with $170 M for 2009

  • Number of PIs –186

  • Average 80 research fellows and 5 graduate students per day


Research and training at sfgh

Research and Training at SFGH

  • Our mission is to provide excellent clinical care for residents of San Francisco while teaching UCSF students/residents.

  • An academic environment is essential to attracting (retaining/recruiting) an excellent faculty to provide this care and teaching.

  • Research is an essential component of an academic environment.

  • Thus, research is essential to the mission of UCSF at SFGH and of the hospital itself.


Challenges replacement of research space

ChallengesReplacement of Research Space

  • Majority of the research is now located in 1916 “red brick buildings”

  • UC Office of the President regulations require that we vacate these buildings by 2015 for seismic reasons

  • Academic Planning Committee recently evaluated future needs and recommended replacement of outdated labs and expansion of research space

  • Currently negotiating with City for land to build state of the art research facility at SFGH


Challenges rebuild of hospital

ChallengesRebuild of Hospital

  • SB 1953 requires all CA hospitals meet new seismic standards

  • General obligation bond ($887.4 M) passed in November (84% approval)

  • Initial construction is underway

  • Will impact parking availability

  • Will generate moves, dust, noise

  • Completion expected by 1/2014


California assembly bill 211 ab 211 january 2009

California Assembly Bill 211 (AB-211)January 2009

  • AB 211 provides fines and civil penalties against any individual who negligently discloses or knowingly and willfully obtains, discloses, or uses medical information in violation of state / federal laws.

  • Enforced by Office of Health Information Integrity (CalOHii)

    • Penalties various fines per violation, one of which has a maximum of US$250,000

    • misdemeanor if the patient suffers economic loss or personal injury

    • potential for civil action by the patient with statutory damages ($1,000) in addition to actual damages

    • notify the licensing board for further investigation or discipline of individual providers

  • May apply to institutions or to individuals or to both


California senate bill 541 sb 541 january 2009

California Senate Bill 541 (SB 541)January 2009

  • SB 541 imposes penalties upon institutions failure to prevent or report for unauthorized access use, or disclosure of medical information.

  • Enforced by Calif. Department of Public Health (CDPH).

  • Penalties:

    • up to US$25,000 per patient

    • up to $17,500 per subsequent access, use, or disclosure

    • $100 per day that the violation is not reported within the 5-day reporting period

  • Applies to institutions, not to individuals.


Sfgh orientation material

SFGH Orientation Material

  • Prior to doing their initial rotation at SFGH, all new residents or fellows must review the SFGH Orientation material.

  • The material is posted on both the GME and the SFGH Dean’s Office web pages, entitled “SFGH Hospital Orientation.” http://www.medschool.ucsf.edu/sfghdean/links

  • For purposes of documentation, residents are to send an email to their program and site coordinators stating that they have completed a review of the hospital’s orientation material. We hope to automate this latter procedure in the near future.


San francisco general hospital

The Heart of the City


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