Q & A with Richard Liekweg,
Chief Executive Officer of the UCSD Medical Center
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Richard Liekweg,
Chief Executive Officer of the UCSD Medical Center. |
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UCSD Health Sciences recently announced its vision for meeting the future needs of its health care patients. According to Richard Liekweg, chief executive officer for UCSD Medical Center, this vision involves transforming both of its medical campuses over the next 15-20 years to improve care and service, and to be more responsive to its patients and the community. Following are Liekweg's responses to some of our questions about the proposal and its possible impacts.
Q. Can you summarize UCSD's vision for its health care system?
A. We have an unprecedented opportunity to improve our health system, based in part on the fact that we must replace our hospital in Hillcrest. After two years of extensive study and analysis, we realized that our patients are demanding more access to outpatient, urgent and emergency care services, and we must be responsive to their needs and expectations. This is the national trend; as sophisticated technologies and treatments are allowing us to provide more care in an ambulatory setting, our patients want us to work harder to keep them out of the hospital. Our response is to provide expanded, state-of-the-art outpatient services and to develop a new center for preventive medicine and community health on our Hillcrest campus, where we will focus on addressing major public health issues like obesity, smoking and violence.
Q. What about the hospital in Hillcrest?
A. Over a 15-20 year time frame, we will also consolidate inpatient beds in a new 500-bed University Hospital at the UCSD East Campus Medical Center, expanding upon the Thornton Hospital. This will allow our physicians, nurses and hospital staff to spend their time in one inpatient facility, surrounded by specialty centers, which is a model that works very effectively in other cities with major academic medical centers, such as Houston where the Texas Medical Center is one of the nation's premier medical complexes.
Q. What will happen to the Hillcrest campus?
A. The Hillcrest campus will continue to be a major medical complex, with a full range of services. We will expand and improve the services our patients use the most - outpatient, urgent and emergency care. And we are very excited about a new center for preventive medicine and population health, where we can provide leadership in keeping people healthy, not just treating them when they're ill or injured.
Q. Why are you moving the hospital beds to campus?
A. We know we have to replace the Hillcrest hospital. Consolidation of inpatient beds on the UCSD East Campus site makes the most sense, for many reasons. By consolidating beds, we will eliminate costly duplication of technology and infrastructure. The campus Medical Center is the site of our new Moores UCSD Cancer Center, the Shiley Eye Center and we are planning a new Cardiovascular Center. This creates a medical hub for specialized care, a model that works very well to support the level of complex care provided in the hospital setting. In addition, proximity to the UCSD campus will provide greater opportunities for translational medicine and clinical research that improves patient care. Finally, Thornton Hospital is a modern new facility that can be most easily and cost-effectively expanded to serve as a consolidated hospital site.
Q. UCSD has a long history of helping the less fortunate. Will this change?
A.
Absolutely not. UCSD has
an unwavering commitment
to the community, as we
have demonstrated by more
than 40 years of service
as a major safety net
provider. We will continue
to care for a broad spectrum
of patients, and, in fact
this vision will improve
access to high quality
health care for everyone.
This plan has generated
a lot of enthusiasm among
our faculty as being a
better way to deliver
high quality care and
service.
Q. What will happen to the patients you serve south of Interstate 8?
A. Our outpatient, emergency and emergency services, which are the services used by most of our patients, will actually be expanded and improved on the Hillcrest campus. All patients who need hospitalization will be treated in our new University Hospital. But I also want to note that, today, UCSD is truly a regional medical center with several nationally respected programs; we serve patients from all parts of San Diego County, and many who travel from outside the county for specialized care. In fact, today, more than half of our 124,500 patients live north of I-8 or outside of San Diego.
Q. What happens to all the existing buildings at Hillcrest?
A. The Hillcrest Campus will house expanded and new programs, including our center of excellence that will focus on preventive medicine and community-based public health initiatives. We will use existing space as well as building new facilities.
Q. What about all the health care employees? Are they concerned about their jobs?
A.
This vision is not about
reducing our services;
we are expanding them.
We project that our patient
volume will continue growing
as the population grows.
Plus, we are talking about
a long-term development
here, phased in over more
than a decade. This is
not going to happen overnight
and people will be informed
of changes every step
of the way.
Q. What year would the Hillcrest hospital actually close?
A.
We would expect the full
consolidation of inpatient
beds to occur in phases,
with completion of our
consolidation by 2020.
Q.
Are you closing your
Emergency Room?
A.
No. As the first phase
of this vision, UCSD will
build an expanded, modern
center for Emergency and
Urgent Care services on
the Hillcrest campus.
The center will also be
equipped to handle large
numbers of patients in
the event of a public
health crisis. The center
will be designed to be
a fully functioning, 24-hour
Emergency Department even
after all of the beds
have been consolidated
in the new hospital. There
are a growing number of
very successful examples
of these free-standing
emergency centers around
the country, and we are
excited about developing
this model to serve San
Diego.
Q. How will this work if a patient needs to be hospitalized?
A. As we have seen in other hospitals across the country that have developed this type of service, when emergency room patients needs hospitalization - which is between 10-15% of our patients today - we will stabilize them and transport them in an emergency transport vehicle to our University Hospital, a trip of about 13 miles. In fact, today, it is common for emergency patients with specialty needs to be transported from community hospitals to major centers like UCSD from distant sites, and even from outside of the county.
Another feature of our new emergency center will be observation beds for patients who have been assessed and treated, and don't need hospitalization, but who still need to be monitored for up to 23 hours before discharge. This will help us keep our emergency treatment rooms open and improve our ability to see patients in a timely manner, while ensuring that those who need a longer emergency room stay have a state-of-the-art setting for their recovery.
Q. What proof do you have that your new vision will be successful?
A. Elements of this plan have already proven successful. I have personally visited free-standing emergency centers run by major hospitals in Fairfield, Virginia and Houston, Texas. They are providing exceptional patient care and service in settings very similar to what we are planning in San Diego. And, the concept of surrounding a major hospital with advanced medical facilities, as will be the case at UCSD's East Campus, excels at world-class medical facilities such as the Mayo Clinic and the Texas Medical Center.
We are ready to take the next step in our evolution and create a truly top-tier University Medical Center, providing 21st century medicine to the San Diego region while advancing technology and treatment through research, and training future generations of practitioners. We believe this is the best way to accomplish that goal.
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