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Introduction. Pediatric & Obstetric Faculty Practice Organization (FPO) Status Report. Stanford School of Medicine Leadership Retreat January 30 - February 1, 2003. Strategic Initiatives. The Strategic Plans for Adult and Peds/Ob Clinical Services have in common: Mission Statement Vision

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introduction
Introduction

Pediatric & Obstetric Faculty Practice Organization (FPO) Status Report

Stanford School of Medicine Leadership Retreat

January 30 - February 1, 2003

strategic initiatives
Strategic Initiatives

The Strategic Plans for Adult and Peds/Ob Clinical Services have in common:

  • Mission Statement
  • Vision
  • Strategic Goals
  • Strategic Activities Regarding Support for:
    • Medical School Professoriate Changes
    • Medical Education Curriculum Changes
    • Integration of Research and Innovation into Clinical Centers of Excellence
pediatric obstetric clinical practice strategic initiatives
Pediatric/Obstetric Clinical Practice Strategic Initiatives
  • 2002 ACCOMPLISHMENTS
  • Increase inpatient services in neonatology in South Bay hospitals.
  • Expanding non-neonatal inpatient programs at SCVM and pediatric cardiac programs at Fresno and Oakland Children’s Hospitals.
  • Continued and expanded over 50 clinical outreach programs.
  • Implementation of CHI clinical initiatives, esp. in cardiac and transplant centers.
  • Continuing education programs for primary care physicians (Livermore).
pediatric obstetric clinical practice strategic initiatives4
Pediatric/Obstetric Clinical Practice Strategic Initiatives
  • 2003 OBJECTIVES
  • Expand inpatient pediatric bed capacity at LPCH and affiliate South Bay hospitals (El Camino Hosp).
  • Improve access to LPCH subspecialty clinics and through clinical outreach.
  • Planning for the move of most LPCH outpatient clinics out of the hospital.
  • Implementation of CHI clinical initiatives, esp. in oncology, CF/pulmonary and neurosciences.
  • Continuing education programs for primary care physicians (Hawaii).
lpch market
LPCH Market

54%

31%

15%

UCSF

Oakland Children’s

  • .58 million pediatric lives in the primary service area
  • 1.2 million pediatric lives in the secondary service area

LPCH

Total

Pediatrics Only

Primary Service Area

70%

Secondary Service Area

21%

Other

9%

Central California Children’s

50 Miles

pediatric obstetric fpo outreach sites 1 o 2 o markets
Pediatric/Obstetric FPO Outreach Sites: 1o & 2o Markets

Stockton

Oakland

San Francisco

Modesto

Pleasanton

Fremont

San Mateo

Redwood City

Mountain View

Santa Clara

San Jose

Santa Cruz

Watsonville

Salinas

Monterey

Secondary Market

Stockton

Cardiology

Gastroenterology

Oakland

Liver Transplantation

CV Surgery

San Francisco

Cardiology

Modesto

Cardiology

Pleasanton

Pediatric Hospitalist

Fremont

Satellite NICU

Cardiology

Perinatal/Neonatal Educational Outreach

Santa Cruz

Satellite NICU

Endocrinology

Genetics

Gastroenterology

Infectious Diseases

Perinatal Diagnostic

Perinatal/Neonatal Educational Outreach

Pulmonology

Rheumatology

Urology

Watsonville

NICU Medical Director

Salinas

Adolescent Medicine

NICU Medical Director

Monterey Cardiology & Gastroenterology

Primary Market

San Mateo

Cardiology

Redwood City

Satellite NICU

Perinatal/Neonatal Educational Outreach

Palo Alto

Gastroenterology

Mountain View

Perinatology/Neonatology Service and Educational Outreach

Santa Clara

Gastroenterology

San Jose

Adolescent Medicine

Endocrinology

Gastroenterology

General Surgery

Urology

pediatric obstetric fpo 3 o markets
Pediatric/Obstetric FPO: 3o Markets

Washington

Seattle/Tacoma

Liver Transplant Clinic

Oregon

Portland

Liver Transplant Clinic

Montana

Billings

Cardiology

Alaska

Anchorage

Liver Transplant Clinic

Hawaii

Honolulu

Liver Transplant Clinic

CALIFORNIA

Chico

Gastroenterology

Eureka

Genetics

Gastroenterology

Fresno

Liver Transplant Clinic

CV Surgery

Redding

Gastroenterology

Sacramento

Liver Transplant Clinic

San Luis Obispo

Cardiology

Sonora

Neurology

Ukiah

Genetics

Gastroenterology

Tacoma

Anchorage, AK

Portland

Redding

Eureka

Chico

Ukiah

Sacramento

Sonora

Honolulu, HI

Fresno

San Luis Obispo

market share of lpch centers of excellence
Market Share of LPCH Centers of Excellence

Est. Market Share

Complex Congenital Heart Surgery (No. CA) 75%

Liver Transplants (No. CA, OR, HI) 60%

Neonatology (Santa Clara & San Mateo Co) 50%

Bone Marrow Transplants (No. CA) 40%

Brain Tumor Neurosurgery (No. CA) 30%

Cystic Fibrosis Center Patients (No. CA) 30%

what do we hope to accomplish with the pediatric obstetric fpo
What do we hope to accomplish with the pediatric/obstetric FPO?
  • Support our academic mission by incorporating education and clinical research as integral components of our practice operations.
  • Directly involve faculty in the day-to-day operations of their practice.
    • Improve efficiency
    • Improve quality and customer service
  • Maximize revenue from patient care encounters.
    • Improve billing, coding, and authorization process
    • Better contracts for pediatric/obstetric services
  • Understanding and oversee the funds flow to the practice from LPCH and the Departments.
  • Align incentives so the cost savings and revenue enhancement accrue back to the practice.
pediatric ob fpo goals mission statement
Pediatric/Ob FPO Goals & Mission Statement
  • Goals:
  • To improve the efficiency and effectiveness of the physician practice and to improve quality of patient care through the establishment of a faculty practice organization in which:
  • The faculty are responsible and accountable for the operations of the practice; and,
  • Incentives are aligned between LPCH and the pediatric/obstetric clinical practice for the purpose of improved performance.

The Pediatric/Obstetric Faculty Practice Organization will advance the missions of Stanford School of Medicine and Lucile Packard Children’s Hospital where they intersect in the delivery of professional medical services.

Mission:

faculty with pediatric ob practice
Faculty with Pediatric/Ob Practice
  • 16 Departments, all of which care for both adults and children, except for Pediatrics and Internal Medicine. (15 Departments will participate)
  • Approximately 350 clinicians who care for pediatric or obstetric patients.
    • 333 show >50% of charges linked to peds/OB
    • 131 show >95% of charges linked to peds/OB
    • 49 UTL, 133 MCL, 114 Staff Physicians, 50 Other
operating principles for pediatric obstetric fpo
Operating Principles for Pediatric/Obstetric FPO
  • Alignment of goals between FPO, LPCH and Stanford School of Medicine through dual reporting structure to Dean and LPCH CEO;
  • No new corporate entity;
  • Faculty-driven governance structure;
  • Faculty responsibility and accountability for financial, quality and service outcomes;
  • Retention of control of Departmental finances within each Department, and retention of control of LPCH finances and clinics within LPCH.
pediatric ob fpo operating principles
Pediatric/Ob FPO Operating Principles
  • Direct linkages to LPCH administration through participation of FPO leaders on LPCH Executive Committee and LPCH CFO on the FPO Management Committee;
  • No incremental FTEs in FPO administrative structure;
  • Commitment to the development of performance standards; and
  • Full time administrative personnel to interface between hospital and clinical practice.
pediatric and obstetric fpo management structure
Pediatric and Obstetric FPOManagement Structure

Stanford Univ. Provost

LPCH Board of Directors

Dean, SSoM

CEO, LPCH

Dept Chairs

FPO Management

Committee Chair

Executive Director

DFAs

Ambulatory Medical Director

Director, Operations

Director, Finance

Clinic Staff

Peds/OB Pro Fee

Billing

Practice-related

Inpatient Staff

peds ob fpo governance structure
Peds/Ob FPO Governance Structure

LPCH

Executive Committee

(Christopher Dawes)

Stanford School of

Medicine

(Philip Pizzo, MD)

FPO Management

Committee

(Ken Cox, MD)

Finance Committee

Quality

Improvement*

Practice Operations

Managed Care

Contracting*

Pro-Fee Billing/

Compliance*

*Sub-committees of existing hospital-wide committees

pediatric ob fpo management committee
Pediatric/Ob FPO Management Committee

FPO Management Committee Membership

Faculty

  • Sr. Associate Dean of Clinical Affairs for Pediatrics and Obstetrics
  • Executive Director, FPO
  • LPCH Chief of Staff
  • LPCH Chief of Surgery
  • Medical Director, FPO Ambulatory Services
  • Chair, FPO Quality Improvement Committee
  • Chair, FPO Finance Committee
  • Chair, FPO Managed Care Contracting Committee
  • Chair, FPO Pro-fee Billing Committee

Administrative Staff

  • FPO Director, Operations
  • FPO Director, Finance
  • Senior Associate Dean, Finances/Administration for SoM
  • LPCH Chief Financial Officer
  • DFA representing Peds/OB DFA Work Group
peds ob service chiefs quarterly attendance @ management committee
Surgery Albanese, Craig

Ophthalmology Alcorn, Deborah

Renal Alexander, Steven

Inf Dis Arvin, Ann

Radiology Barth, Richard

Cardiology Bernstein, Daniel

Rad Onc Donaldson, Sara

OB Druzin, Maurice

Liver Transp Esquivel, Carlos

Infant Dev Fleisher, Barry

Intensive Care Frankel, Lorry

Pathology Geaghan, Sharon

Neurology Hahn, Jin

Cardiac Surgery Reddy, Mohan

Genetics Hoyme, Eugene

Neurosurgery Huhn, Stephen

Pain/Anesth Gregory Hammer(Interim)

Hand Surgery Ladd, Amy

Dermatology Lane, Alfred

Hematology/Oncology Link, Michael

Adolescent Medicine Litt, Iris

General Pediatrics Mendoza, Fernando

ENT Messner, Anna

Pulmonary Moss, Richard

Child Psychiatry Reiss, Alan

Ortho Rinsky, Lawrence

Kidney Transplant Salvatierra, Oscar

Rheumatology Sandborg, Christy

Plastics & CFA Schendel, Stephen

Urology Shortliffe, Linda

Neonatology Stevenson, David

Allergy Umetsu, Dale

Endo & Diabetes Wilson, Darrell

Peds/OB Service ChiefsQuarterly Attendance @ Management Committee
management committee responsibilities
Management Committee Responsibilities
  • Review and further develop the vision
  • Perform strategic planning for the pediatric and obstetric practice and the LPCH clinics
  • Establish performance and productivity standards for the pediatric and obstetric clinical practice
  • Design and approve the FPO financial model and monitor overall performance
  • Establish and monitor incentive plan as approved by SoM and LPCH
  • Approve/direct pediatric and obstetric FPO management team and oversee operating performance
  • Establish key FPO policies
fy03 goals
FY03 Goals

By the end of FY03, the FPO expects to accomplish the following:

  • Establish the governance structure and hire the FPO administrative team;
  • Create an integrated statement of revenue and expense for the Pediatric/Obstetric practice, reflecting all practice related income and expense regardless of hospital or departmental genesis;
  • Establish performance goals and an incentive model for implementation in FY04; and,
  • Assume accountability for the operations of the clinical practice, including the LPCH ambulatory clinics.