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San Francisco General annual report: $1.3B budget, ED triage gains and lab system upgrade highlighted
Summary
ZSFG leadership presented an annual report noting a roughly $1.3 billion budget, improvements in ED triage that cut leave-without-being-seen rates to under 2% in 2025, full nursing staffing gains, and the recent Epic Beaker laboratory system go-live at ZSFG.
San Francisco General Hospital leaders presented the hospital'level annual report to the Health Commission, highlighting operational improvements, staffing gains, capital projects and an information-technology transition in the labs.
CEO Susan Ehrlich told the commission ZSFG serves as the city's only Level 1 trauma center and safety-net hospital, handling roughly 73,000 emergency and psychiatric visits and about 1,300 births per year. Ehrlich listed the hospital's budget at about $1.3 billion and said the hospital relies heavily on Medi-Cal, Medicare and city funding.
Ehrlich and other presenters highlighted multiple quality initiatives. A multidisciplinary Emergency Department triage redesign reduced the leave-without-being-seen rate from 7.4% in December 2022 to 5.4% within three months and sustained below 2% for consecutive months in 2025; officials noted a 63% reduction in disparities for Black/African American patients leaving without being seen. The CHC Healthy Steps program, adopted in 2019, was recognized for expanding early childhood behavioral health: as of fiscal year 2025 it provided more than 9,000 dyadic behavioral health visits to 3,000+ children under age 6.
Laboratory modernization was also emphasized. Deputy Director Baba and Vice President Guillermo recognized the core lab team for completing an Epic Beaker transition that went live on Oct. 21, 2025, integrating three lab systems across the Department of Public Health and adding automation and new analyzers while maintaining 24/7 operations.
Ehrlich described capital projects including clinical lab moves, dialysis upgrades and an adolescent unit funded by a state B-CHIP grant with substantial completion estimated around 2027. She also acknowledged partnerships with UCSF and the San Francisco General Hospital Foundation for research and fundraising.
Next steps: leaders said the annual report will be posted on the department website and shared with foundation members and other stakeholders; commissioners suggested highlighting key slides for foundation events and broader social media outreach.
