In its final report to Mayor Gavin Newsom, the Blue Ribbon Committee on San Francisco General Hospital's Future Location reached a conclusion that building on the existing Potrero Avenue site is the best choice considering the alternative.
The question before the committee was whether to recommend that a new SFGH be built at the existing location or whether the public hospital should be built at Mission Bay, adjacent to where UCSF is developing a 43-acre teaching and research campus. UCSF officials are eyeing Mission Bay as a future location for a new specialty hospital.
Both SFGH and UCSF Medical Center's hospitals on Parnassus and Mount Zion campuses must be rebuilt to meet California seismic safety regulatory requirements for acute care hospitals under Senate Bill 1953. SFGH and UCSF are not alone in facing these strict standards - 40 out of 56 hospital buildings in San Francisco must be replaced, according to the report.
SFGH's 23-acre campus consists of 14 buildings, the oldest of which dates to 1915. The main hospital was built in 1974 and does not meet SB 1953 seismic safety standards. It must be retrofitted or rebuilt by 2013.
The committee strongly recommends that the City and County of San Francisco begin the process of determining whether a general obligation bond measure to rebuild SFGH can be approved by voters in 2006. The estimated costs of building a new 267-bed acute care hospital at Potrero Hill range from $737 million to $808 million, according to the report.
The committee's consensus recommendation to rebuild SFGH at its existing Potrero location is based on several factors. Chief among them are that:
• Space is limited at Mission Bay: SFGH will need an estimated 8.5 acres to rebuild a 267-bed hospital, but there are only 7.2 acres of land available to buy near the proposed UCSF hospital site and the land is not contiguous.
• Higher costs at Mission Bay: Rebuilding and operating SFGH at Mission Bay would be more costly than rebuilding and operating at the Potrero Avenue location because of construction costs, land acquisition costs and higher operating costs incurred by running two campuses.
• More coordinated care: Rebuilding SFGH on Potrero Avenue will result in a better-coordinated system of ambulatory, acute and emergency care services since all services will be located on one site.
• Better access to emergency services for neighbors: SFGH is the primary acute care hospital for uninsured Mission District residents, who would experience reduced access to care if the hospital were to be rebuilt at Mission Bay.
Challenges Ahead
Even though the committee recommends rebuilding SFGH on Potrero Avenue, it acknowledged that three major issues will need to be addressed as the plan goes forward.
First, since it will take about eight years to construct a new hospital, SFGH officials must work to minimize the inevitable disruption that will occur from building a new hospital on the site while the existing hospital is still operating. "Care should be taken in selecting the site of the new hospital on the Potrero campus to minimize disruption from construction," the report states.
Second, SFGH should continue to work closely with neighbors, some of whom object to the addition of a medical helipad, which is necessary to provide high quality and timely trauma and emergency services. SFGH, as the only Level One trauma center in the City, has been in the process of preparing an Environmental Impact Review for placing a helipad on the Potrero campus.
Third, UCSF and SFGH should continue to strengthen their historic relationship "given the critical role UCSF faculty play in the delivery of high-quality care to SFGH patients."
"In particular, it is important to address the research facility needs (identified by UCSF as a UCSF responsibility) of UCSF faculty, practicing at SFGH to ensure that there is a strong academic and clinical environment that benefits both patients and practitioners. The committee believes that it is crucial to preserve and enhance this relationship even though SFGH and UCSF will not be in close physical proximity to each other," the report states.
The relationship between UCSF and the City and County of San Francisco began in the late 1800s. Under an affiliation agreement, UCSF provides all of the physicians necessary for operating a level-one trauma center, an emergency department and all other clinical services at SFGH. In addition to a strong partnership in patient care, UCSF uses SFGH as a major center of medical education training and research.
After the committee reached its consensus, members David A. Kessler, dean of the UCSF School of Medicine and vice chancellor of medical affairs, and Sue Carlisle, associate dean of the UCSF School of Medicine at San Francisco General Hospital, issued an email about the future of SFGH on Sept. 9. They stressed UCSF's commitment to maintaining academic excellence at SFGH, through its support of the clinical training and research programs, which both focus on caring for the patient population at SFGH.
"We realize that the quality of clinical care at SFGH is inextricably tied to the excellence of our academic programs and we understand that research is a vital part of the mission and climate of SFGH. As such, we are strongly committed to maintaining a critical mass of research at the Potrero Avenue site," they wrote.
A UCSF team, headed by Bruce Spaulding, vice chancellor for University Advancement and Planning, is now developing a plan to replace the seismically unsafe brick research buildings at SFGH.
In addition to Kessler and Carlisle, members of the SFGH committee included Andre Campbell, chief of the medical staff at SFGH, Kevin Grumbach, chief of family and community medicine at SFGH, Mark Laret, chief executive officer of UCSF Medical Center, and Spaulding.
Source: Lisa Cisneros
Related Links
Dean Kessler, Associate Dean Carlisle Comment on Future Location of SFGH
SF General Needs a Helipad for the Next Disaster, San Francisco Chronicle, Open Forum
