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1st appeared
12 November
1999 UCSF Reshapes Future of Mount Zion While UCSF and Stanford continue to dissolve the merger, faculty and staff continue to work toward expanding outpatient services at Mount Zion and consolidating inpatient services at the UCSF Medical Center as part of a plan to reduce costs across the clinical enterprise. Under the plan, Mount Zion Medical Center and the cluster of buildings around it will become a hub of growing outpatient services, says Chief Medical Officer Ted Schrock. As co-chair of the Mount Zion Transition Steering Committee along with Brian Goodell, UCSF Stanford chief administrative officer, Schrock says he meets twice a week with faculty and staff to try to make the transition as smooth as possible for everyone involved. The first surgical services were transferred to the UCSF Medical Center earlier this month. Admission to inpatient units at Mount Zion will continue until early December, when physicians will be asked to refer admissions to the Parnassus site. Mount Zion will offer cancer services, ambulatory surgery, primary care, women’s health services, a dermatology practice, sports medicine, an integrative medicine research program, a center for imaging, laboratory and complex diagnostic testing for cardiac and pulmonary illnesses, a center for the treatment of chronic pain and a new urgent care center. The ambulatory surgery center will feature five rooms where surgeons will provide outpatient procedures as well as those that require less than a two-day stay in the hospital. On Wednesday, Nov. 17, Mount Zion will open the adult urgent care center to treat minor medical problems that require prompt attention. Such conditions include minor wounds, skin infections, simple fractures, headaches, stomachaches, common sports injuries and sexually transmitted diseases. Located on the second floor at 2380 Sutter St., the urgent care center will be staffed by UCSF internists who will be available to treat patients on a walk-in basis from noon to 8 p.m. seven days a week. Paul Nadler, a UCSF faculty physician who is board certified in internal medicine and who has extensive experience in outpatient urgent care, is the new medical director of the urgent care center. While some have expressed hope that the break up of the two-year-old merger may mean that UCSF will keep Mount Zion operating as an acute care hospital, UCSF officials say that’s not financially feasible. "The fiscal circumstances that led UCSF to the decision to reconfigure services at Mount Zion have not changed in any way," says Chancellor Bishop. "If anything, dissolution of the merger has only made belt-tightening at the UCSF Medical Center more urgent." Indeed, the medical center will continue to follow a financial recovery plan under direction of The Hunter Group that calls for cutting costs in part by reducing jobs at both hospitals and closing the emergency department and inpatient units at Mount Zion. Some people propose renewing efforts to obtain financing from the state or some other source to save Mount Zion’s 113-year history as an acute care hospital. But UCSF officials say that despite their best efforts over the past six months, they have not found a way to make Mount Zion financially solvent over the long run without implementing the plan now under way. Over the past decade, the UCSF Medical Center has subsidized the operations at Mount Zion, essentially absorbing $200 million in losses. Nearly all of the $4 million operating loss attributed to UCSF hospitals in September came from Mount Zion. " Such subsidies are no longer possible," Bishop says. "The changes we are making at Mount Zion are designed to keep the facility a place of medical discovery and public service." UCSF Stanford officials have notified the State Department of Public Health about the intent to close the emergency department on December 23 to comply with state and city requirements to provide 90 days notice of reductions in medical services. But keeping the ER open until then may be difficult as emergency room doctors accept offers for other jobs and nursing positions become hard to fill on both sites, Schrock says. UCSF Stanford officials will meet with the San Francisco Public Health Commission on Tuesday, Nov. 16, to discuss closing the emergency department. "We are trying to find other physicians to continue to keep the emergency department open until December 23, including looking at other hospitals in the area. If we cannot find physicians and nurses to staff both sites, then we will have patient safety and quality issues that may force us to close the department earlier than anticipated," says Schrock. A team of attending physicians, consultants, residents and nurses will remain on the Mount Zion inpatient units to care for patients admitted to the emergency department and intensive care for as long as the ER remains open, he says. Mount Zion’s daily patient census currently stands at 65, a number considered too small to operate an acute care hospital efficiently, officials say. But that number of patients can be accommodated at the UCSF Medical Center, where the current patient census stands at about 346 with a maximum capacity of 440, according to Schrock. Meanwhile, the UCSF Medical Center is opening three more operating rooms, adding 10 beds in the emergency department, expanding its critical care unit, and making administrative space available to physicians who relocate their practices to Parnassus, Schrock says. The reorganization at Mount Zion will not adversely affect the Cancer Center, recently designated by the National Cancer Institute (NCI) as a national center with a three-year grant to finance research infrastructure and administration. The NCI designation came about after officials announced that changes are necessary at Mount Zion. Officials say the reconfiguration of services at Mount Zion may actually benefit the cancer center, which still needs additional space. Construction of the clinical cancer center adjacent to Mount Zion continues with completion expected next spring. This facility will house a state-of-the-art radiation therapy center, an infusion center with double the current UCSF chemotherapy capacity, the Carol Franc Buck Breast Care Center and multidisciplinary cancer clinics. Links: The UCSF Medical Center: Present and Future -- Message From the Chancellor Faculty Look Forward to Rebuilding UCSF Medical Center Stanford Starts Termination of Merger Report to UCSF Stanford Health Care Board on the Future of Mount Zion Source: Lisa Cisneros
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