An innovative vision for delivering 21st century health care has been announced by the University of California, San Diego (UCSD) Medical Center. The plan includes a new emphasis on preventive medicine and community health; expands and modernizes outpatient, urgent care and emergency services, and includes a new state-of-the-art University Hospital that will serve the San Diego region and beyond.
The plan, anticipated to take at least 15-20 years to complete, expands outpatient services at the university’s Hillcrest and UCSD Campus Medical Centers, recognizing that advances in technology and drug therapies allow for even highly complex care to be provided on an outpatient basis. UCSD’s broad-based health programming in population studies and outreach will be intensified in a new center in on its Hillcrest campus dedicated to advancing community health.
“We have an unprecedented opportunity to improve health and health care, and respond to the needs of our patients, by enhancing outpatient services, and establishing a center for community-wide health initiatives that address major public health issues like obesity,” said Edward W. Holmes, M.D., UCSD’s Vice Chancellor of Health Sciences and Dean of the School of Medicine. “In addition, by consolidating our inpatient beds in a new University Hospital on UCSD’s main campus, we will better serve the patients who come to us from all over the County for specialized hospital services.”
This new vision recognizes that the future of medicine is outpatient care, said Holmes, with increasingly sophisticated procedures, including surgeries, now being performed in doctor’s offices. Nationally, 90% of patients use outpatient services at least once a year; 85% of UCSD’s patients only use outpatient services, an additional 11% use outpatient services in addition to having a hospitalization.
Holmes also stressed the importance of prevention, with diet and lifestyle playing a substantial role in the health of populations. He cited smoking and obesity as just two examples of public health issues that lead to many of society’s major health problems, including cancer, heart disease and diabetes.
UCSD’s new model envisions the Hillcrest campus as the site of three new centers of excellence:
- An innovative Center for Emergency/Urgent Care in a new and expanded facility, that will include 23-hour observation beds for patients who do not need hospitalization, but need additional monitoring before they can be discharged;
- A Center for coordinated community and population-based health programs and patient education emphasizing disease and injury prevention, in partnership with private and public agencies;
- An expanded state-of-the-art Outpatient Health Center offering a full range of primary and specialty care services, including imaging and surgery centers.
The UCSD East Campus medical center will be the site of:
- A consolidated 500-bed University Hospital serving all patients who need inpatient care;
- Enhanced and expanded outpatient and emergency services;
- Specialty centers focusing on heart disease and cancer, emphasizing outpatient care and access to clinical trials.
UCSD’s new health system model results from two years of extensive analysis and planning, a process initially launched to address pressing facility needs on the Hillcrest medical center campus. The 45-year-old UCSD hospital in Hillcrest is out of compliance with current California seismic standards and must be replaced.
“As we evaluated our options, we concluded we have an obligation to reinvent the traditional health system model,” Holmes noted. “The hospital is no longer the focal point for services. Hospitals of the future will serve as regional centers of excellence for complex, highly specialized procedures and intensive care, that require an inpatient stay. We need to do a better job of keeping people healthy, in addition to caring for them when they become ill.”
Richard Liekweg, Chief Executive Officer of UCSD Medical Center, observes that a growing and aging population is demanding the convenience of cost-effective health care that keeps them out of the hospital.
“This vision emphasizes prevention, population-based health, and expanded programming that addresses the behavioral, dietary, environmental and societal issues underlying disease and injury, such as obesity, tobacco use and violence,” Liekweg said.
When patients require hospitalization, the complexity of their injury or illness often requires teams of highly trained specialists from different disciplines, he added. By consolidating inpatient beds in one modern hospital facility, UCSD’s physicians, nurses and healthcare personnel will have more time to dedicate to patient care, rather than traveling to cover two hospitals. This will also improve collaboration and consultation over patient cases, said Liekweg.
Consolidation of UCSD’s inpatient beds will also eliminate the need for costly duplication of technology, and reduce expensive facility and infrastructure investments required to maintain two hospitals, allowing for more resources to be directed toward patient care, said Liekweg.
Liekweg said this strategy will take several years to implement. The first phase will include the new Emergency Room and Urgent Care Center in Hillcrest, which will be designed to continue serving the community with urgent and emergency care services after full consolidation of inpatient beds in the new UCSD East Campus hospital.
Completion of the hospital consolidation would not occur until the 2015 to 2020 timeframe.
UCSD Healthcare is part of the UCSD Health Sciences division, which encompasses the UCSD School of Medicine, the Skaggs School of Pharmacy and Pharmaceutical Sciences at UCSD, and the healthcare system of services that includes the hospitals, emergency departments and outpatient centers in Hillcrest and on the UCSD campus, and an outpatient center in Scripps Ranch. The UCSD Medical Center mission is to provide the highest quality care to improve the health of the community, while supporting the clinical, educational, and research activities of the Schools of Medicine and Pharmacy.
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