Merged organization launched, clinical integration continues
UCSF Stanford Health Care was launched Nov. 1 as leadership of the new organization continued efforts to integrate clinical services for the newly merged entity.

The new organization began operations with a consolidated payroll and benefits system for some 11,000 employees.

The merged organization consists of Stanford Health Services, which includes Stanford University Hospital, the Stanford Faculty Practice Group, and Lucile Salter Packard Children's Hospital; UCSF Medical Center, including UCSF/ Mt Zion; the UCSF Medical Group and clinics that are owned by or affiliated with the two medical centers. Not included are San Francisco General Hospital, Langley Porter Psychiatric Institute, the Veterans Affairs medical centers, and UCSF Fresno. The Stanford and UCSF schools of medicine remain governed by their respective universities.

Meanwhile, the Leadership Group of the new entity last month responded to faculty recommendations about how to integrate clinical services under the merger in a report that outlines how the new organization intends to put those suggestions into practice.

The report was presented to faculty serving on the eight "clinical integration teams" at an Oct. 8 dinner in Burlingame.

"Although we have made considerable progress in a number of areas, particularly in governance and in the process for structuring the Physician Organization, it is very clear that clinical integration is a work in progress - one that will undoubtedly be discussed and refined for literally years to come," said Bruce Wintroub, chief medical officer of UCSF Stanford Health Care.

In its report, the Leadership Group described the governing bodies of the merged organization and outlined their areas of responsibility. The report also described procedures for an elected, broadly representative Physician Organization, two members of which will sit on the Leadership Group. The report outlined plans to pilot adult service lines in three areas: cardio, neuro and transplant (liver, kidney and kidney/pancreas).

On the subject of funds flow, the report set forth guiding principles but offered few specifics. The basic plan, said Chief Financial Officer Lawrence Furnstahl, is to maintain funds flow at the status quo for the first year and to design a new, integrated system for the third year, with year two being a period of transition and testing.

"The issues involved in creating service lines and in designing funds flow mechanisms are extremely complex," Eugene Bauer, Stanford University vice president for medical affairs and dean of the School of Medicine, commented last month after the report was released. "We must be certain that we have analyzed our options thoroughly and have modeled the plans in sufficient detail that we minimize the risks to the two schools and their clinical departments."

The Leadership Group, the primary policy-making body of UCSF Stanford Health Care, currently has 15 members. They are - in addition to Wintroub, Furnstahl and Bauer - Peter Van Etten, CEO; Bill Kerr, chief operating officer; Christopher Dawes, interim president and CEO of Lucile Packard Children's Hospital; Haile Debas, chancellor and dean of the UCSF School of Medicine; Lee Goldman, UCSF chair of medicine; Judith Swain, Stanford chair of medicine; Gary Glazer, Stanford chair of radiology; Peter Gregory, Stanford senior associate dean of clinical affairs; Nancy Ascher, vice chair of surgery at UCSF and chief of transplant services; Larry Shapiro, UCSF chair of pediatrics; Bruce Reitz, Stanford chair of cardiothoracic surgery and acting chair of surgery; and Theodore Schrock, UCSF chair of surgery.

Details of the Leadership Group's response to the recommendations of the clinical integration teams, including the governance structure, funds flow and plans for creating service lines in the new enterprise are available from the online version of the Medical Staff Update.

This article is summarized from versions originally published in Faculty Focus, a newsletter of UCSF Stanford Health Care, and Stanford Report, a weekly newspaper for Stanford University faculty and staff.
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