ucsf clinical enterprise strategic plan presentation to the clinical affairs committee
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UCSF Clinical Enterprise Strategic Plan Presentation to the Clinical Affairs Committee. Prepared for. October 22, 2008. Strategic Plan: Timeline - What stage is the plan in?. Are there still opportunities for input?. Clinical Enterprise Strategic Plan. 2002 Strategic Plan Previous Context - PowerPoint PPT PresentationTRANSCRIPT
UCSF Clinical Enterprise Strategic PlanPresentation to the Clinical Affairs Committee
October 22, 2008
Prepared for
2
SEPTAUG
Stakeholder Interviews
Town Halls*
DEC JUL OCT
Readiness vs. 2015, Identify IssuesResponses, implications, & requirementsSub-Committee Reports
STAGE 2 – UCSF READINESS AND RESPONSES TO CHALLENGES
Steering Committee
Strategic Retreats
Sub-Committees
Strategic Oversight Committee
Confirm process, work plan, and rolesUnderstand UCSF’s DNA (Acuity model) Set the stage: In 2015, we believe…
Create a shared understandingOrganize to address the challenges
MEETINGS
Sub-Comm. Outputs and Implications
Draft UCSF Strategic RoadmapShared strategies for a shared visionConsensus on strategic planModification of 10-year financial plan Submission of final report
STAGE 3: BRINGING IT ALL TOGETHER: UCSF’S ROADMAP TO THE FUTURE
STAGE 1 – CHARTING THE LAY OF THE LAND: 2015 MARKET
JUNMAYAPRMARFEBJAN
MONTHS
SEPTAUG
Stakeholder Interviews
Town Halls*
DEC JUL OCT
Readiness vs. 2015, Identify IssuesResponses, implications, & requirementsSub-Committee Reports
STAGE 2 – UCSF READINESS AND RESPONSES TO CHALLENGES
Steering Committee
Strategic Retreats
Sub-Committees
Strategic Oversight Committee
Confirm process, work plan, and rolesUnderstand UCSF’s DNA (Acuity model) Set the stage: In 2015, we believe…
Create a shared understandingOrganize to address the challenges
MEETINGS
Sub-Comm. Outputs and Implications
Draft UCSF Strategic RoadmapShared strategies for a shared visionConsensus on strategic planModification of 10-year financial plan Submission of final report
STAGE 3: BRINGING IT ALL TOGETHER: UCSF’S ROADMAP TO THE FUTURE
STAGE 1 – CHARTING THE LAY OF THE LAND: 2015 MARKET
JUNMAYAPRMARFEBJAN
MONTHS
**
Strategic Plan: Timeline - What stage is the plan in?
Are there still opportunities for input?
3
Clinical Enterprise Strategic Plan
2002 Strategic PlanPrevious Context
Significant growth imperative
Increased capacity
Improved financial & operating performance
Increased customer service/satisfaction
Created Mission, Vision, and Values
Planned Mission Bay
2008 Strategic PlanCurrent Challenges
Capacity constrained
Challenging FY08 budget
Increased competition
Continued shift in insurance dynamic
SB1953 seismic requirements – Mission Bay cost
4
Clinical Enterprise Strategic Plan
Mission:
Caring, Healing, Teaching and Discovering.
Vision:
To be the best provider of health care services, the best place to work
and the best environment for teaching and research.
Values: Embodied in the acronym PRIDE:
P for Professionalism, how we conduct ourselves and our business
R for Respect for our patients, families, ourselves and each other
I for Integrity, always doing the honest, right thing
D for Diversity, understanding and embracing the diverse beliefs, needs and expectations of our patients, community and employees
E for Excellence, what we strive for in everything we do
Foundational Statements
5
This 2008-2015 Clinical Enterprise Strategic Plan defines the next evolution of UCSF, building on existing strengths and focusing
on opportunities for improvement
Strategic Plan: Direction
Three key goals serve as the foundation for this Strategic Plan
Clinical Growth
Best Care
Shared Accountability
Financial Performance
6
Strategic Plan: Themes
CLINICAL GROWTH
1. Maximize the Potential of the UCSF Inpatient Facilities
2. Match Patient Mix to UCSF’s Mission and Program Capability
3. Expand Functional Ambulatory and Office Capacity
4. Achieve a More Effective UCSF Referral Outreach
BEST CARE
5. Create the Next Generation UCSF Care Delivery Model
6. Provide the Highest Value Care to Patients
7. Educate, Recruit and Retain the Best Talent
SHARED ACCOUNTABILITY
8. Define a Stronger Culture of Shared Accountability and Action
9. Achieve the Operating and Clinical Cost Improvements Necessary to Sustain a 6% Operating Margin (language still being reviewed)
7
Strategic Plan: CLINICAL GROWTH
Recommendation 1.1: Increase functional bed capacity by 60+ beds across both major campuses
Strategy 1.1.A: Complete 16 ICU-bed addition on Parnassus, to be operational by end-2008
Strategy 1.1.B: Decrease risk-adjusted inpatient ALOS to the average UHC benchmark or better
Strategy 1.1.C: Improve average bed occupancy at Mt. Zion to 75% (from less than 60% today), adding an additional 15-20 beds to functional inpatient capacity
Theme #1: Maximize the Potential of the UCSF Inpatient Facilities
8
Strategic Plan: CLINICAL GROWTH
Recommendation 2.1: Focus adult incremental growth in high and moderate complexity care
Recommendation 2.2: Ensure that programmatic growth occurs in a rational and controlled fashion
Recommendation 2.3: Ensure future patient mix supports UCSF’s educational and research requirements
Recommendation 2.4: Encourage Departments to commit to a set of institutional policies that are intended to stabilize UCSF’s sponsor mix to ensure financial viability
Theme #2: Match Patient Mix to UCSF’s Mission and Program Capability
9
Strategic Plan: CLINICAL GROWTH
Recommendation 3.1: Improve exam room utilization (visits/room/day) to allow a 10%-15% growth in ambulatory visits within existing infrastructure
Recommendation 3.2: Ensure that there is sufficient office space available to support projected growth of the clinical enterprise
Recommendation 3.3: Focus the development of any ambulatory growth (exam room or outpatient ancillary capacity) off the main campus
Theme #3: Expand Functional Ambulatory and Office Capacity
10
Strategic Plan: CLINICAL GROWTH
Recommendation 4.1: Create and implement an Institutional Outreach Oversight Committee that will act on behalf of the enterprise and be responsible for prioritizing and coordinating future UCSF outreach initiatives
Recommendation 4.2: Work closely with the School of Medicine, translational research scientists and others to ensure linkages and appropriate volumes for teaching requirements and clinical trials through outreach initiatives
Recommendation 4.3: Focus on building and enhancing relationships with community providers in Northern California to ensure patients are cared for in the appropriate care settings
Recommendation 4.4: Focus UCSF marketing strategies on increasing awareness of the UCSF brand regionally
Theme #4: Achieve a More Effective UCSF Referral Outreach
11
Strategic Plan: BEST CARE
Recommendation 5.1: Increase the number of non-resident (mid-level providers) and mixed (both mid-level providers and house staff) services to reduce reliance on the resident model
Recommendation 5.2: Explore residency expansion initiatives in select departments, if aligned with institutional clinical priorities without affecting the quality of the training programs
Recommendation 5.3: Develop core teaching and non-resident staffing models for inpatient units as needed by service
Recommendation 5.4: Restructure workflow on inpatient units to allow all clinical providers to spend more time with the patient
Recommendation 5.5: Ensure the care delivery model supports a consistent standard of clinical care regardless of time of day or day of the week
Theme #5: Create the Next Generation UCSF Care Delivery Model
12
Strategic Plan: BEST CARE
Recommendation 6.1: Create an organization and infrastructure that allows the UCSF clinical enterprise to tie its value proposition to superior quality, patient safety and clinical outcomes
Recommendation 6.2: Communicate UCSF’s results in clinical quality, patient safety and clinical outcomes to a broad external audience
Recommendation 6.3: Enhance service standards for the UCSF clinical enterprise so that it is competitive in the Bay Area market
Theme #6: Provide the Highest Value Care to Patients
13
Strategic Plan: BEST CARE
Recommendation 7.1: Develop recruitment initiatives that enable UCSF to meet its goals around clinical growth and patient mix
Recommendation 7.2: Create retention initiatives that allow UCSF to identify and develop the next generation of UCSF leadership
Recommendation 7.3: Strengthen the relationship between UCSF and its employees
Theme #7: Educate, Recruit and Retain the Best Talent
14
Strategic Plan: SHARED ACCOUNTABILITY
Summary Assessment of Today’s Model:
High level of patient service variability, financial result
High level of decentralization, local discretion
Low level of shared success definition, expectations
Low level of transparency across the enterprise
High level of frustration, sense of lost potential
Theme #8: Define a Stronger Culture of Shared Accountability and Action
15
Strategic Plan: SHARED ACCOUNTABILITY
Expectations – Defining Success (per KSA)
1. Define clinical service credo distinct from academic freedoms
Service to patients the priority in clinical enterprise work
2. Clear service standards expected across all clinical participants
3. Operating leadership roles aligned with demonstrable expertise
4. Participation a major institutional value, i.e. not discretionary
16
Strategic Plan: SHARED ACCOUNTABILITY
Transparency – Reporting Progress (per KSA)
1. Reporting vs. (just) approving clinical enterprise aims
Current clinical enterprise strategic plan the starting basis
2. Use of comprehensive dashboards and scorecards
3. Broad, disciplined disclosure of progress and lack thereof, good and bad
4. Scheduled use of advisory boards, open faculty sessions to vet status
17
Strategic Plan: SHARED ACCOUNTABILITY
Incentives – Reinforcing Success (per KSA)
1. Recognize patient service acumen by the clinical faculty
Leadership roles, governance participation, compensation
2. Align institutional clinical support with results and plan aims
3. Align career opportunity pathway with proven clinical excellence
18
Strategic Plan: SHARED ACCOUNTABILITY
Ten Year Financial Plan Assumes Several Key Assumptions:
Reduced Length of Stay to UHC Benchmarks (6.3 to 5.85 in select services)
Decrease in FTEs/Adjusted Occupied Bed (8.08 to 7.76)
Increase in Case Mix Index (1.98 to 2.08)
Flat Volume in MediCal
Theme #9: Achieve the Operating and Clinical Cost Improvements Necessary to Sustain a 6% Operating Margin
19
Financial Implications
UCSF Finanical ForecastNet Income - Scenario Analysis
0
40,000
80,000
120,000
160,000
FY2008 FY2009 FY2010 FY2011 FY2012 FY2013 FY2014
Do
llars
( in
th
ou
san
ds)
Base Scenario Scenario 1 - ALOS Scenario 2 - CMIScenario 3 - Payor M ix Scenario 4 - Combined Revenue Scenario 5 - FTE per AOB (8.08)
20
Other Questions Posed by CAC in Advance
How will the strategic plan impact outpatient services? In particular, access to clinics for patients established at UCSF or referred from SACC or the emergency department?
What are the plans for improving services at the ACC clinics?
What is the timeline for implementing a usable EMR in the ACC and eliminating STOR?
What plans are in place for allowing the building of patient registries based on diagnosis so that quality improvement for populations with specific diagnoses, such as diabetes, asthma, COPD, can be implemented and tracked?
21
Strategic Plan: Next Steps
Next steps include:
SOM Faculty Council (done), Clinical Affairs Committee, Academic Planning and Budget (done), DOM Chiefs Meeting (TBD), SON Faculty (done)
Please advise if you would like us to present at one of your Department meetings
Two Town Halls Led by Interim Dean Hawgood and Mark Laret tomorrow
Formal approval from:
Chancellor’s Office
Faculty Senate
Dissemination to the Public
On-line postings – official Summary of the Plan
Public Relations and Marketing (articles, brochures)
Create Detailed Implementation Plan - How can CAC be more involved in implementation and oversight of this plan, as well as future medical center initiatives?
Address Issue of Shared Accountability