From the Chief of the St. Luke's Medical Staff: CPMC Begins New Collaborative Relationship

December 7, 2007

To the Medical Staff:

At the MEC [Medical Executive Committee]meeting last night we discussed a number of issues relevant to our practices and the future of St. Luke’s. Dr. Brotman attended and was particularly open to our concerns, listening and making suggestions.

On the immediate matter of the nurse’s strike, we will be in the same mode as in October. Admissions are already being routed to Davies and Pacific campuses with the intent to bring the acute census down to 20 and 4 ICU by December 13. OB will be sent to the California campus, which will maintain full staffing with travelers. St. Luke’s will maintain emergency surgery and OB teams during the strike. Members of the MEC asked why St. Luke’s has to be reduced while California remains at full capacity. The chief answer is in the number of hospitals that are being struck, which decreases the availability of travelers. California also has OB and neonatal capacity that would be difficult to replicate at St. Luke’s and cannot be transferred to either of the other campuses.

After elaborating on Sal Rosselli’s recent loss of statewide power, the reasons for the strike, and CPMC’s chosen role as “employer of choice” (providing the best compensation package and working conditions in this area), Dr. Brotman joined in our discussion of the workers’ compensation program, which had been failing at St. Luke’s and was destroyed by the cancellation of contracts by Sutter last July. We emphasized the strategic location of St. Luke’s for light industry in the city and its long history of providing the service, as well as its economic importance for our doctors. The MEC passed the attached resolution prepared by Marc Snyder, and Judy Li agreed to a task force to regain this lost business.

Many of us spoke up about the deplorable condition of med/surg with the closure of the 10th floor and the rising census (70 yesterday). We urged administration to end the 4-bed wards on 9 and 11 and return many of the 2-bed rooms on 9 to single-bed capacity and thus “flex” the opening of 10 at a lower census. They are listening, but change may not occur until after the strike.

We discussed the Special Care Unit that is to replace the NICU and emphasized that the change cannot happen until there has been full staff training to meet the needs of the new program. There are still reservations about this move among the pediatrics and OB staff. The pediatricians are working hard to maintain their acute care program in St. Luke’s, which has provided outstanding service to the community.

Finally, Dr. Brotman spoke about a new direction in planning for the future of the four campuses. The initial phase was rolled out at Monday’s meeting of the African-American Health Disparities Coalition. It consists of going outside the institution and involving other stakeholders in what is called a “mutual gains” approach. CPMC has heard loud and clear that this community needs St. Luke’s to stay open. The financial burden may be eased by the termination December 31 of the per diem contract with Medi-Cal, which will allow the hospital to get a much higher rate for inpatient care.

I hope to see all of you at the Annual Meeting on December 20.

Jerry Franz
Chief of Staff