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    Creating a Blueprint for the New St. Luke's

    Community Participation Is Key to Future of Essential Services

    California Pacific Medical Center is in the midst of developing an overall plan to bring the next generation of health care services to the people of San Francisco. As we’ve previously reported, that plan calls for building a new acute care community hospital on the St. Luke’s Campus.

    “Initially, the overall plan was spurred by state regulations requiring all inpatient hospital facilities to meet strict earthquake safety standards by 2013, which was later extended to 2015,” explains California Pacific Director of Enterprise Development Geoffrey Nelson. “Plans outlining our initial strategic response were required by 2001, and preliminary plans for construction had to be submitted by the end of December 2008.”

    The current plan includes changes for all four campuses – St. Luke’s, Pacific, California and Davies – as well as a new, main hospital on Cathedral Hill. The new hospital on the St. Luke’s Campus is part of the recommendations made by the Blue Ribbon Panel of San Francisco leaders convened in the spring of 2008 and approved by the California Pacific Medical Center Board of Directors in September 2008.

    “After evaluating our options at each existing campus, we determined that retrofitting inpatient facilities at the California and Pacific Campuses would have caused massive disruptions in patient services, including maternity care,” Nelson explains. “There simply was nowhere else to move those patients. We also considered building a new facility at the California Campus, but that would have been another logistical nightmare with disruption of critical patient services.”

    The financial and physical obstacles to retrofitting, as well as the lack of other available facilities in the city, eventually led to a proposal to build a new inpatient facility on Cathedral Hill, at Van Ness Avenue and Geary Boulevard. The new Cathedral Hill Campus would consolidate many acute care and critical care inpatient services in one central location.

    “The proposal to build the Cathedral Hill Campus was developed long before St. Luke’s became a California Pacific Medical Center Campus,” Nelson says. “When St. Luke’s became part of the organization, we initially proposed focusing on preventive and primary care at the St. Luke’s Campus and consolidating its acute care services at the Cathedral Hill site. Legitimate concerns were raised, however, about the need for an acute care community hospital in the South of Market district, and the board ultimately endorsed the Blue Ribbon Panel’s finding that the hospital should be rebuilt and modernized.”

    Moving Forward

    To meet the time constraints in the state’s seismic upgrade laws, California Pacific Medical Center had to quickly develop an initial set of drawings for the hospital at St. Luke’s, defining the basic space requirements by the end of December 2008.

    “The good news is, we made the state’s deadline and remain in compliance with their requirements,” Nelson says. “We took great care to plan for a facility of the right size to suit the needs of the community while allowing for future flexibility. But the architectural efforts are just starting. Now we are in the process of mapping out the existing flow of patients through each of the major areas of the hospital and discussing ways to create an ‘optimal flow’ for each area. The physical design of the building will support these optimal flows.”

    In addition to seeking input from the St. Luke’s Medical Staff and other St. Luke’s personnel regarding patient flow, the facility designers also have been listening and responding to neighbors’ questions relating to the Blue Ribbon Panel’s proposed placement of the new facility and hospital operations.

    “We have held public meetings where we heard significant neighborhood concerns regarding traffic, noise and integrating the design of the building with the surrounding community,” Nelson notes. “We intend to continue working with our neighbors to address their concerns and get their feedback on the design of the facility. We have the ability to make changes to our building plan based on community input, but must remain responsive to the hard-won guidance from the Blue Ribbon Panel. We also are continually checking in with city officials and other interest groups.”

    The current timeline for constructing the new hospital at St. Luke’s begins with environmental certification hearings with the city Planning Commission, which could occur as early as December 2009, with other public meetings between now and then to provide information to the public.

    “We hope to break ground for the new hospital in mid-2010, with an estimated completion by the end of 2014,” Nelson says. “We realistically cannot delay the project any longer without the risk of missing the state’s deadline for seismic safety upgrades. Hospitals missing these deadlines run the risk of financial ruin through the rescinding of reimbursement payments to non-complying facilities.

    “The bottom line is, this must be a cooperative effort between California Pacific and the community,” he adds. “We are trying to be a responsive member of the community, and we need the support of the people in the community in order to provide the services they need and deserve.”

    For more information about the plans for the future of St. Luke’s and other California Pacific Campuses, as well as updated schedules of upcoming community meetings and other events, visit