2011 Annual Report - UCSF Medical Center

2011ANNUAL REPORTA G R O U N D B R E A K I N G Y E A R

GROUNDBREAKING VISIONDear friends,The word “groundbreaking” often defines innovative and pioneeringevents. So it’s an especially appropriate description of activities in late2010, when we broke ground on our new children’s, women’s andcancer hospitals at Mission Bay. That day marked the culmination ofnearly one decade of work that began with an ambitious vision: createa state-of-the-art, environmentally friendly medical center where wecan provide unparalleled care to our patients.The steel structures that since have risen from the site are changingthe San Francisco skyline – and the future of health care. Hundredsof the world’s top clinicians and scientists will work together intechnically sophisticated facilities, translating science into patient care.The new hospitals also will become a training ground for team-based,interdisciplinary care that capitalizes on the expertise of all the healthprofessionals at UCSF.Even as we build our new medical center, we’re continuing to embracethe latest advancements in technology at our existing hospitals tomake the care we provide today safer and more personalized. Ournew electronic medical record is streamlining care by creating oneelectronic chart accessible to all the clinicians involved with a patient.Our automated hospital pharmacy, believed to be the nation’s mostcomprehensive, has administered 1.5 million doses error-free.We take seriously our responsibility to the hundreds of thousands ofpatients who put their well-being, and often their lives, in our hands.And we will never stop pushing ourselves to provide them with thehighest-quality, safest care. As we look forward to 2012 and beyond,it’s important to recognize how fortunate we are to be surrounded bydonors, community members, patients, faculty, staff and supporterswho are equally passionate about our vision. Without them, withoutall of you, our groundbreaking efforts would not be possible. To eachof you, we are profoundly grateful.Mark R. LaretChief Executive OfficerUCSF Medical CenterUCSF Benioff Children’s Hospital

LEADERSHIP *THE REGENTS OFTHE UNIVERSITY OFCALIFORNIA(includes ex-offi ciomembers)Richard C. BlumJerry BrownDavid CraneDarek DeFreeceWilliam De La Peña, MDRussell S. GouldRex HimeEddie IslandOdessa P. JohnsonGeorge KiefferSherry L. LansingMonica C. LozanoHadi MakarechianGeorge M. MarcusAlfredo Mireles, Jr.Gavin NewsomNorman J. PattizJohn A. PérezBonnie ReissFrederick RuizLeslie Tang SchillingTom TorlaksonBruce D. VarnerPaul D. WachterMark G. YudofCharlene ZettelPRESIDENTMark G. YudofUCSF CHANCELLORSusan Desmond-Hellmann,MD, MPHEXECUTIVE VICECHANCELLORAND PROVOSTJeffrey Bluestone, PhDSENIOR VICECHANCELLORJohn PlottsFinance andAdministrationDEAN, SCHOOLOF MEDICINESam Hawgood, MBBSEXECUTIVE VICEDEAN, SCHOOLOF MEDICINEKeith R. Yamamoto, PhDVICE DEANS,SCHOOL OFMEDICINENeal Cohen, MD,MPH, MSMichael HinderyAdministrationDavid M. Irby, PhDMedical EducationNancy Milliken, MDBruce U. Wintroub, MDDEAN, SCHOOLOF NURSINGDavid Vlahov, PhD, RNDEAN, SCHOOLOF PHARMACYMary Anne Koda-Kimble,PharmDDEAN, SCHOOLOF DENTISTRYJohn D.B. Featherstone,MSc, PhDDEAN, GRADUATEDIVISIONPatricia Calarco, PhDCLINICAL CHAIRSAbul K. Abbas, MBBSPathologyRonald L. Arenson, MDRadiologyNancy L. Ascher, MD,PhDSurgeryMitchel S. Berger, MDNeurological SurgeryRenée L. Binder, MDPsychiatry(interim)Michael Callaham, MDEmergency MedicinePeter R. Carroll, MD,MPHUrologyDavid W. Eisele, MDOtolaryngologyDonna Ferriero, MDPediatricsLinda Giudice, MD, PhDObstetrics, Gynecologyand ReproductiveSciencesKevin Grumbach, MDFamily and CommunityMedicineStephen L. Hauser, MDNeurologyTalmadge King, MDMedicineClifford Lowell, MD, PhDLaboratory MedicineMervyn Maze, MB, ChBAnesthesia andPerioperative CareStephen D. McLeod, MDOphthalmologyMack Roach III, MDRadiation OncologyKimberly Topp, PhDPhysical Therapy andRehabilitation SciencesThomas Parker Vail, MDOrthopaedic SurgeryUCSF MEDICALCENTERCHIEF OFFICERSMark R. LaretChief Executive Offi cerKen JonesChief Operating Offi cerBarrie StricklandChief Financial Offi cerJay HarrisChief Strategic PlanningOffi cerJoseph BengfortChief Information Offi cer(interim)David OdatoChief Administrative andHuman Resources Offi cerJoshua Adler, MDChief Medical Offi cerSheila Antrum, RN,MSHAChief Nursing andPatient CareServices Offi cerEXECUTIVEDIRECTORSKathleen BalestreriPatient ServicesJohn ChapmanClinical ServicesReece FawleyHealth Plan Strategyand TransplantationBrigid IdePatient Safety and QualityCindy LimaMission BayHospitals ProjectTim MahaneyFacilities and SupportServicesDavid MorganAmbulatory CareKaren Rago, RN, MPAService LineAdministrationBruce U. Wintroub, MDDermatologyKimberly Scurr, RNChildren’s Hospital(interim)*On June 30, 2011

YEAR IN REVIEW 2010–2011As the fiscal year began, UCSF Medical Center was once again named among the top 10 hospitals in thenation by U.S.News & World Report. In the months that followed, the medical center continued to leadthe way by championing changes that seek to greatly improve the lives of patients and their families.From ensuring patient safety through embracing the latest technology to breaking ground on innovativefacilities that will set a new standard of care, UCSF Medical Center continued to push the horizons ofmedicine for patients today and for generations to come.Groundbreaking atMission BayAfter a decade of planning, UCSFbroke ground in October 2010 ona state-of-the-art and sustainablemedical center at Mission Bay –a 289-bed, 878,000-square-footcomplex that promises to transformcare for children, women andcancer patients. More than 200community members, electedofficials, donors and UCSFleaders, faculty, staff and patientscelebrated the milestone.UCSF Medical Center andUCSF Benioff Children’sHospital Rank Among theNation’s BestUCSF Medical Center rankedamong the nation’s top 10premier hospitals for the 10thconsecutive year, and UCSFBenioff Children’s Hospitalranked among the nation’sbest children’s hospitals innine specialties, according toannual surveys conducted byU.S.News & World Report.Employees celebrate the hospitals’ groundbreakingUCSF Benioff Children’s Hospital ranked among nation’s bestFirst UCSF Clinics ImplementElectronic Health RecordsUCSF implemented our firstelectronic health record at theMount Zion campus on April 6,2011, transforming how healthcare providers, staff and patientsexchange information. The system,called APEX, puts increasedemphasis on patient safety andmedical error prevention bycreating one electronic patientchart that’s accessible acrossthe institution, increasing thecontinuity of care.UCSF Osher Center forIntegrative MedicineCelebrates New BuildingUCSF’s center for integrativemedicine opened the doors of itsnew home at the UCSF MountZion campus. The UCSF OsherCenter for Integrative Medicineoffers the best of modern medicinewith established healing practicesfrom around the world, and is amajor hub of research, educationand patient care in integrativemedicine.New home for UCSF Osher Center for Integrative Medicine

New UCSF RoboticPharmacy Aims toImprove Patient SafetyAlthough it won’t be obvious toUCSF Medical Center patients,behind the scenes a family of giantrobots now counts and processestheir medications. With a newautomated hospital pharmacy,believed to be the nation’s mostcomprehensive, UCSF is usingrobotic technology and electronicsto prepare and track medicationswith the goal of improving patientsafety.UCSF Challenge for theChildren Breaks $1 MillionThe UCSF Challenge for theChildren, a social media-basedfundraising contest that won thesupport of prominent SiliconValley companies, tech industryexecutives and other celebrities,raised more than $1 million forUCSF Benioff Children’s Hospital.Nearly 165,000 people donated tothe highly successful campaign.Fetal Surgery Found toBe More Effective ThanOperating After BirthThirty years ago, the first humanfetal surgery was performedat UCSF. Now, a randomized,controlled trial led by UCSFresearchers has proven definitivelythat babies who undergo anoperation to repair the birth defectspina bifida while still in the wombdevelop better and experiencefewer neurological complicationsthan babies who have correctivesurgery after being born.UCSF Challenge for the Children raises more than $1 millionRobotic arm in the new hospital pharmacyUCSF Medical Center ranked among the top 10 in the nationUCSF Cardiovascular Careand Prevention Center atMission Bay OpensThe 236,000-square-foot center,which opened on November 1, 2010,brings together heart care patients,world-class clinicians and leadingedgeresearchers in an enterprisedesigned to accelerate thetranslation of basic research intoclinical findings and, eventually,therapies for patients. Featuring afull range of interdisciplinary careand research in the new UCSFSmith Cardiovascular ResearchBuilding, the center is housedwith the world-renownedCardiovascular Research Instituteas well as cardiology andvascular practices and theCenter for Prevention of Heartand Vascular Disease.UCSF Forms Cancer CarePartnershipsThe UCSF Helen Diller FamilyComprehensive Cancer Centerjoined forces with Enloe MedicalCenter, Chico; CommunityHospital of the MontereyPeninsula, Monterey; andRenown Institute for Cancerin Reno, forming an affiliationof cancer programs to enhancepatient care and improve accessto top-level medical experts. Theseaffiliations will bring a team oflocal and national experts togetherto offer patients the latest therapiesand promising new treatments.UCSF is also affiliated with twoother California cancer centers:Mercy Medical Center Redding andSt. Helena Hospital, St. Helena.The new UCSF Smith Cardiovascular Research Building

FINANCIALSFiscal years ending June 30, 2010,and June 30, 2011(dollars in thousands)BALANCE SHEET2011 2010In fiscal year 2011, UCSFMedical Center provided$140 million in care forwhich it received no payments(charity care andbad debt) or payments thatwere less than the cost ofthe care provided (Medi-Calreimbursement shortfall).UCSF Medical Center offersmedical care to children,emergency patients andthose community memberswho require our specializedservices, regardless of abilityto pay.AssetsTotal current assets 737,099 590,861Capital assets, net 957,406 824,471Cash restricted for hospitalconstruction 628,185 –Other assets 30,991 28,933Total assets 2,353,681 1,444,265Liabilities and Net AssetsTotal current liabilities 224,112 198,794Long-term debt and capital leases,net of current portion 946,642 262,810Other liabilities 59,423 50,732Total liabilities 1,230,177 512,336Net assets 1,123,504 931,929Total liabilities and net assets 2,353,681 1,444,265INCOME STATEMENTOperating RevenueNet patient service revenue 1,864,052 1,766,688Other operating revenue 25,152 21,069Total operating revenue 1,889,204 1,787,757Operating ExpensesSalaries and employee benefi ts 841,510 793,754Supplies and purchased services 700,318 669,988Depreciation and amortization 81,474 77,790Other 91,494 95,646Total operating expenses 1,714,796 1,637,178Income from operations 174,408 150,579Non-operating expenses, net 32,559 (1,474)Net income 206,967 149,105ADDITIONAL INFORMATIONUncompensated/undercompensatedcare 140,426 137,957Reinvestment in facilities andequipment 216,512 168,532

Outpatient activityPatient visits in thousandsInpatient activityPatient days in thousandsBUILDING A HEALTHYCOMMUNITYNet incomeDollars in millionsPatient mix*Adult: 71%Pediatric: 29%UCSF Medical Center isthe leading hospital inSan Francisco and NorthernCalifornia and a destinationfor patients with complexconditions from around theworld. The medical centeris self-supporting anduses its margins to meetimportant needs in ourcommunities, includingtraining physicians andother health professionals,supporting medicalresearch, providing careto the medically andfinancially needy, andbuilding and operatingfacilities to serve the diverseneeds of our patients.Patient origin*San Francisco residents: 28%Other California residents: 68%Outside of California: 4%* Based on patient days

"PRINTED ON NEENAH ENVIRONMENT PAPER: FSC CERTIFIED, 80% POST-CONSUMER WASTE FIBERS • 2.12-MKT-11-01060The 2011 annual report of UCSF Medical Center and UCSF Benioff Children’s Hospital was produced by the Marketing Department.Marketing DirectorErika SmithMarketing ManagerAndrea EastmanManaging EditorBrad T. SnyderArt DirectorEllen HeywoodUCSF Medical CenterUCSF Benioff Children’s Hospital505 Parnassus Ave. • San Francisco, CA 94143(888) 689-8273www.ucsfhealth.orgwww.ucsfbenioffchildrens.orgTo support UCSF Medical Centerand UCSF Benioff Children’s Hospital:Office of Development220 Montgomery St., Fifth Floor • San Francisco, CA 94104(415) 476-5640www.ucsfhealth.org/donate© 2012 The Regents of the University of California

UCSFCHAMPIONSAt UCSF Medical Center,the champions don’t weargold medals. They wearscrubs, nurses’ smocksand lab coats. They coverpost-chemo baldness withwigs, and tiny preemieheads with the world’ssmallest watch caps. Theywear downtown suits, hardhats, gowns that open atthe back and sweatpantsfor long nights by a sickchild’s bedside. At UCSF,ordinary-looking peopleare often extraordinary.Patients, caregivers,scientists, philanthropicpartners – they are thefaces of advancedscience translated intoinnovative medicine. Andthey are the inspirationfor The Campaign forUCSF Medical Center –transforming health carefor the world, starting righthere in San Francisco.MEET THE CHAMPIONS

Art KernBoard member, Prostate Cancer Foundation /Advocate for prostate cancer researchWhen Art Kern discovered he had prostate cancer, he didn’t justbecome a UCSF patient. He became part of the research. And throughhis perseverance, insight and generosity, he is influencing prostatecancer solutions that will help men everywhere.In the mid-’90s when Kern’s doctor saw an elevated PSA reading, he said, “Don’t worry.”After all, Kern was not yet 50 years old, and he was healthy.But when Kern mentioned his PSA level to anendocrinologist he knew from UCSF, he hearddifferent advice: See Dr. Peter Carroll, a leadingexpert in prostate cancer. “Being treated by Peterprobably saved my life,” Kern now says. Gratitude,combined with the same thirst for innovation thatmade him a business leader, inspired Kern to crossover from prostate cancer patient to research advocate.“UCSF at Mission Bay will bea place where 21st-centuryscience meets 21st-centurymedicine, with the best researchand the best care available.”Along with Andy Grove, then CEO of Intel, and Van Van Auken of the venture capital firmMayfield Fund, Kern helped organize fellow prostate cancer survivors to share their recoveryexperiences, raise research funds and provide invaluable feedback to UCSF researchers.“The more involved I get, the more I admire the people and the spirit here,” Kern says.“Collaboration has always been the ‘secret sauce’ of UCSF. And, just as Silicon Valley’sinnovations grow from teamwork, it’s increasingly clear that solutions to diseases like canceraren’t going to come from one researcher working alone. If the promise of personalizedmedicine is going to happen anywhere, it will be at UCSF.”3

Gideon, Susie and Jonathan YuBoard Member, UCSF Foundation (Gideon) / Mom and philanthropist (Susie) /Next-generation entrepreneur (Jonathan)Sometimes, Gideon gazes upon his 3-year-old son, Jonathan, asleep andsnuggled up against mom Susie, and thinks: “This is what heaven mustlook like.” Then he remembers how that heaven was threatened.Jonathan was just 2 months old when his parents rushed their crying baby to a local emergencyroom. Eleven grueling hours passed before X-rays, blood tests and scans revealed a brokenbone and something more worrisome: a potential issue found in a scan of Jonathan’s brain.“With three Mission Bayhospitals in place, UCSF will beeven stronger. We’re proud tocontribute in any way wecan to that outcome.”When no one at the hospital could provide theassistance or information they so frantically sought,the Yus mobilized every acquaintance in search ofhelp for their son. The resounding recommendation:Get Jonathan to UCSF.Over the next several days, the compassionate,informed attention of a UCSF specialist in pediatricneurology put them at ease, Gideon and Susie say.With a clear sense of their options, and the recommendation to monitor Jonathan closelyas he approached each new developmental target, they brought their angel home.Today, Jonathan is a normal, happy and – most important – healthy little boy. And Gideonand Susie are active angels of UCSF, through philanthropy and through the great gift oftheir time, energy and considerable talents. “When I think about the next chapter of my life,I know I want to contribute to great causes like UCSF,” says Gideon.4

Cassandra RobertsonRN / MSN / Advocate for patients and staff / Gospel singer / InspirationIt takes a strong personality to turn an operating room full of surgeons,technicians, scrub nurses and residents into a team. With rare, salt-ofthe-earthcharacter and a gospel singer’s power to inspire, CassandraRobertson unites them all.Here’s a story that says everything about Robertson: The father of a very sick child hadreached his breaking point. He refused to allow doctors to proceed with surgery. So greatwas his pain, other hospital staff members were afraid to enter the child’s room.But Robertson took the chance. She walked her friendlyface in and brokered a truce with the frightened andangry dad. She supported the physician while he madethe case for surgery. She dressed the dad in scrubs andtook him on a tour of the operating room, so he couldsee where his child would be. Then, with the surgeryunder way, she called the father every 30 minutes toreport on progress. So successful was the outcome thatthe man came back with treats for the staff, plus twowords that meant the world: “Thank you.”“It can be tough operating onkids in a facility that’s reallydesigned for adults. UCSF’s newchildren’s hospital at Mission Bay,built for children from the groundup, will change all that.”The joy of working harmoniously toward a shared goal – caring for ailing children andsupporting their families – is similar to the satisfaction Robertson experiences when shesings. “I don’t want to sound corny, but the link between my music and my career is reallythat my passion for both is rooted in the same inspiration. I don’t sing R&B. I sing gospel,”she says. “And my faith makes me passionate about caring for people, period.”5

Laura EssermanMD / MBA / Director, Carol Franc Buck Breast Care Center /Keeper of MemoriesIn 17 years at UCSF, Laura Esserman has seen thousands of patients.She’s helped many vanquish breast cancer. She’s been by thebedsides of others at the end. But her work for each woman beginsin the laboratory, where she remembers her patients’ stories, theircourage and their hope.The understanding that breast cancer is not just one disease drives Esserman’s research. “Ourjob is to discover as much as we can about the biology of each breast cancer and determinehow well the treatments work for each, so patients can make informed decisions,” she says.“UCSF is the mostcollaborative place I’ve worked.I am so much more capablebecause of the people I work with.Here, science is a team process.”In one of Esserman’s groundbreaking initiatives,called ATHENA, doctors and researchers from fiveUC medical centers are collaborating on the care of150,000 women to understand why some developbreast cancer and to find more effective ways tocustomize prevention and treatment. Anothereffort – the I SPY Trial, involving 20 major U.S.cancer centers – is characterizing breast cancersaccording to distinctive molecular markers andusing an innovative trial design to test whichpromising new drugs have the greatest impact ondifferent tumor profiles.Both efforts support the collaboration Esserman thinks is essential to discovery. And both putEsserman on the brink of breakthroughs that will enable doctors to tailor therapies to eachwoman’s tumor and even prevent breast cancer – work that will accelerate when UCSF’swomen’s and cancer hospitals share a modern campus with researchers at Mission Bay.6

UCSFCHAMPIONSUnited in our passion forinnovation, our compassionfor each other and ourgenerosity, we are creatinga model for tomorrow’shospitals and a source ofinspiration for tomorrow’schampions. And we’relooking for a few more tojoin us – people like you.When completed, UCSFMedical Center will offerexceptional care, acceleratedresearch, collaborativediscovery, measurableexcellence and a broadimpact. Be our Champion,and help us change morelives than we can imagine.BE A CHAMPIONTo learn more about what you can do to help champion our cause,call The Campaign for UCSF Medical Center at (415) 476-4647 or visit support.ucsf.edu.For the full versions of these stories, and many more, visit missionbayhospitals.ucsf.edu/champions.January 2012 | Photography: Jock McDonald