First Appeared Thursday, 09 September '04

UCSF Officials Define Vision for Future Growth

Completing a comprehensive four-year planning process, UCSF leaders are recommending a bold plan to build state-of-the-art technologically advanced patient care facilities at three major sites as part of a long-term vision to advance UCSF’s education, research and health care missions.

The plan is imperative say campus leaders, who aim to solve three major challenges: comply with stringent state-mandated earthquake safety standards for hospitals, address functional obsolescence of aging facilities, and increase inpatient and outpatient capacity to meet growing patient demand and objectives in the UCSF Medical Center strategic plan.

The plan is also imaginative – born from the minds of many -- as the campus and community participated in a historic opportunity to rethink UCSF’s future and reconfigure its vast network of clinical, research and educational programs.

UCSF officials will present the recommendations and an environmental impact report to the UC Board of Regents for its consideration in early 2005.

The vision for UCSF’s growth and development will be reviewed with the campus community at a noontime town hall meeting in Cole Hall on Friday, Sept. 10 – the sixth in a series on the topic. The plans also will be presented to the public at meetings in San Francisco at 7 p.m. on Monday, Sept. 27 at UCSF Mission Bay, Genentech Hall, and on Wednesday, Sept. 29, at the Millberry Conference Center on the Parnassus campus.

If approved by the Regents, the plan would be implemented in phases over the next 15 years. Key elements of the plan are:

• MISSION BAY: Developing integrated specialty hospitals including a UCSF Children's Hospital, a UCSF Women’s Hospital and the first phase of a UCSF Cancer Hospital on the Mission Bay campus by 2013, together with outpatient facilities and a new translational research center to speed the transfer of new medical knowledge to clinical practice. The number of beds in the first phase is expected to total about 210, with a possibility of expansion in later phases.

• PARNASSUS: Making major renovations to the 550-bed Moffitt/Long hospital buildings that constitute UCSF Medical Center at Parnassus Heights by 2013, followed by building a new inpatient hospital pavilion to replace Moffitt with about 130 beds.

• MOUNT ZION: Expanding use of UCSF Mount Zion as a campus for ambulatory care, outpatient surgery and related clinical research and education.

“These new facilities will be patient-centered and will provide effective, safe, affordable and equitable care for San Franciscans and others throughout the West,” says Mark Laret, chief executive officer of UCSF Medical Center. “They will be designed to meet patient, clinical research and medical education needs and will be flexible enough to accommodate changes in technology, health care and education.”

The recommendations were developed through an extensive planning process overseen by the Chancellor’s Advisory Committee on the Long Range Development Plan (LRDP) Amendment. That committee recently presented the recommendations to UCSF Chancellor Mike Bishop, who approved the plan for conveyance to the Regents.

“I am grateful to the many members of the campus and local community who joined in the searching deliberations that gave rise to the recommendations,” Bishop says. “The plans have my strong support. They address the needs of our clinical enterprise in a thoughtful manner and lay the groundwork for a more effective integration of our clinical, teaching and research missions.”

While the initial reason for convening the LRDP committee was to address UCSF hospital facilities in light of state seismic laws -- which aim to protect hospitalized patients from harm in an earthquake -- the planning process encompassed how UCSF could advance its clinical, research and educational missions across all campus sites.

Craig Van Dyke, professor and chair of the UCSF Department of Psychiatry, served as chair of the LRDP committee, and Bruce Spaulding, vice chancellor for University Advancement and Planning, served as vice chair. Convened in March 2001 with a broad representation of campus leaders, the LRDP committee oversaw the planning process working with the Clinical and Research Planning Subcomitttee.

Laret and David Kessler, dean of the UCSF School of Medicine and vice chancellor for medical affairs, co-chaired the subcommittee that evaluated five campus locations for hospital replacement using detailed screening criteria. With input from the Academic Senate, faculty, staff, students, consultants, members of the public and the UCSF Community Advisory Group (CAG), a long-term vision for UCSF’s clinical and research programs emerged.

“While the recommendations complete the LRDP amendment committee’s work, we now begin a process which will involve multiple task forces to do the detailed planning for individual campuses and programs. We trust that we can count on your continued contribution to this important process,” Van Dyke says in a message to the campus community.

Tasks include developing business plans, a master site plan for either the current Mission Bay campus or on newly acquired land, and reviewing plans with the California Environmental Quality Act, as well as getting approval by the Regents. The plans may be refined further as a result of these actions.

The need to replace the 49-year-old Moffitt hospital on the Parnassus campus and the older Mount Zion hospital is critical to the University’s long-term success. UCSF Medical Center is one of the highest ranked hospitals in the country, yet it is the smallest among its peers.

Campus leaders stress that they are committed to making improvements at all three main sites: Parnassus, Mount Zion and Mission Bay. The University plans to invest in tools, technology and campus shuttle transportation to optimize communication and interaction within and among the various sites.

“UCSF is and will continue – under this plan -- to be great across the board,” Kessler says. “We have chosen to foster excellence at multiple locations because no one location is going to be able to do it all. To advance the science and art of medicine, it is very important to have depth and integration of clinical, academic and research programs at each location. Each site will have a different emphasis, but each one will be great in its own way.”

Reaching Consensus

UCSF officials originally explored the feasibility of building one large 650-bed hospital. But they determined that no one site is large enough to accommodate all the clinical, education and research needs of a top-ranked health sciences university. UCSF also could not afford to finance the construction of a large hospital in the short-term, campus officials say.

Even so, the final recommendation to operate separate hospitals at Mission Bay and Parnassus Heights, while now nearly universally accepted, was not the first choice of some campus leaders or faculty.

But the University was left with few viable options, says Peter Carroll, professor and chair of the UCSF Department of Urology and a member of the Clinical and Research Planning Subcommittee. “A single site campus would be my preference, but I realize that to do all the things that we’re currently doing and to do more we need to build at Mission Bay as well as Parnassus,” he says.

“We’ve got to realize that the Parnassus site has many constraints, the space ceiling and old buildings,” Carroll says. “Mission Bay gives us an opportunity to grow our programs and grow them strategically with all of our already scheduled plans for research and academic programs.”

Mary Anne Koda-Kimble, dean of the UCSF School of Pharmacy, concurs. “The ideal scenario, of course, would be to gather up all of our programs from around the Bay Area and co-locate them at a single location,” she says. “But, for many reasons, this is just not possible within our working time frame. Taking into consideration all of the complexities, I support the ‘next step’ scenario we have developed.

By further decentralizing our activities, we will have to learn to think, work and communicate in new ways,” Koda-Kimble adds. “This will be vital to maintain the unanticipated collaborations that make all that we do so enjoyable and unique. The new hospitals will further strengthen our patient care services and broaden clinical and learning opportunities for our faculty and students. This is a turning point in UCSF's story.”

Indeed, many faculty and staff involved in the consensus-building process consider arriving at the final recommendation a significant step for UCSF.

“I think UCSF is at a crossroads,” says Carroll, who joined the faculty in 1996. “I see UCSF Mission Bay as allowing UCSF to grow in ways we could only imagine. Building new hospitals there, while investing in the Parnassus campus, represents the single most important point in UCSF’s history.”

Sam Hawgood, professor and chair of the UCSF Department of Pediatrics and chief of neonatology at UCSF Children’s Hospital, who participated in the process over the past few years, describes the recommendation as a “futuristic vision.” A member of both the LRDP committee and clinical and research subcommittee, he says, “It’s a good solution to a very complicated and difficult problem and it allows us to develop three outstanding campuses that will remain linked and interrelated.”

A 20-year faculty member at UCSF, Hawgood says the many hours spent in planning sessions was worth the effort. “This is probably the most important decision UCSF will make, second only to building a campus at Mission Bay. We felt good that it was an open process and that all alternative models were considered.”

As has been the practice since 1990, UCSF invited the participation of the Community Advisory Group (CAG) early on in the planning process. The CAG has met seven times since October 2001 to discuss options for replacing the hospital. Dennis Antenore, a charter member of the CAG, is heartened by the University’s continued willingness not only to encourage a dialogue about its options with community members, but also to respond to their concerns about future expansion.

“I’m very gratified that the University took input and advice from the community,” he says. “We’ve had a frank exchange of views and discussed some very important matters to the general community, as represented by the Community Advisory Group, and the final plan reflects that.”

For Antenore, an attorney who lives near the Parnassus campus, one of the biggest concerns was the importance of maintaining emergency services on Parnassus to serve the western part of the city. Antenore also served on the CAG’s hospital replacement action team, which has met 10 times since October 2001. Its main focus has been developing, in concert with the LRDP committee, a set of criteria used in evaluating the different sites.

To get input from the public at large so far, UCSF Community & Governmental Relations hosted three information meetings about the hospital replacement project at Parnassus, Mount Zion and Mission Bay in May 2003. Some 115 neighbors participated in these meetings, where they expressed nearly unanimous support for the multi-site scenarios over building one large hospital. Most believe a big hospital would be out of scale and character of the neighborhoods considered.

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