November 26, 1998

At our Nov. 24 communications meeting Tom Basler, Ph.D., director, Libraries and Learning Resources Centers, gave the management team an update on progress with development of the MUSC facilities master plan. This plan will serve as a guide for the development of the MUSC campus over the next 15 to 20 years. Highlights from Dr. Basler’s presentation are outlined below.

Our management team also received reports at the communications meeting, as outlined below, concerning three Trident Area Community Excellence (TACE) awards given to the Medical Center. One of the awards recognized the Medical Center’s Quality Improvement Network (performance improvement program) and two awards were for the outstanding teamwork within the Transplant Center. Congratulations for a job well done!

Finally, I encourage all Medical Center employees to complete and return the organizational assessment survey as soon as possible. The results of the survey will be widely communicated and we plan to use the findings to focus upon areas needing improvement.

Thank you and have a happy holiday season.

W. Stuart Smith, Interim Vice President for Clinical Operations Interim CEO, MUSC Medical Center

Facilities Master Plan

• Dr. Tom Basler explained that more than one year ago the President’s Council appointed a facilities master plan committee representing all areas of MUSC. The committee was charged with updating the facilities master plan developed in the early 1990’s and with overseeing the formulation of a facilities master plan that can be a vision of MUSC as it physically might exist in 15 to 20 years.
• A request for proposals was issued for necessary architectural and engineering consulting to assist in preparing the plan and 18 firms replied. Our Board of Trustees selected Perkins & Will Architects and Engineers from Atlanta. The Perkins & Will firm also contracted with Ayers, Saint, and Gross of Chicago...a firm which has worked extensively with prestigious academic health centers.
• The consultants were asked to help develop the facilities master plan and implementation schedule which considers projected capital funds and addresses at least the following issues and concerns:
• deferred maintenance
• campus infrastructure
• general space problems
• student space (such as meeting space, conference rooms and large volume meetings)
• education, research and patient care space q traffic/parking
• campus quality/image
• campus signage
• future growth, development and land use allocation
• local government issues
• design standards/guidelines
• Basler reported that to date Perkins & Will has accomplished the following:
• assessed 5 million square feet of campus space (still in progress)
• reviewed assessment with groups and individuals
• charted and gave a numerical rating for all the space
• performed comparisons with similar institutions, i.e., Johns Hopkins, University of Virginia, etc.
• A visioning retreat was held recently which included approximately 70 people. Perkins & Will used the input received during that retreat and from their other work to draft a preliminary plan. The final plan is projected to be completed in March 1999.
• Basler listed the following as critical points which should be addressed in the final plan:
• overall definition of campus (marking boundaries of the campus)
• continue to meet with neighborhoods and civic organizations
• the need for a central campus point, focal point of campus
• additional parking q additional research space
• additional space in general (teaching, meeting, studying, etc.)
• realistic approach to the clinical enterprise strategic plan and changes in MUSC’s response to the health care environment
• Basler encouraged everyone to complete the survey which Perkins & Will is using for gathering input. The survey can be accessed through the MUSC home page on the internet. Basler stressed that everyone should let Perkins & Will know of their thoughts and opinions about the campus. A paper copy of the survey is also available at various locations around campus. You can also contact Basler by e-mail or at 792-9211.

TACE Awards

TACE Organization Quality Award

• Karen Pellegrin, Ph.D., director, Quality Management, announced MUSC recently received the TACE Organization Quality Award which recognizes the entire organization for business excellence and quality achievement. This award is based on the Malcolm Baldrige award and on total quality management practices. Pellegrin reported that awards were also received by Bosch, Charleston Air Force Base and Roper Care Alliance at a recent awards ceremony.
• TACE has four levels of recognition for organization awards: World Class, Outstanding Achievement, Significant Progress and Serious Commitment. MUSC was recognized for Outstanding Achievement.
• The awards process requires an application and a site visit by the TACE committee.
• The awards criteria consists of the following:
• Organization--its purpose, identity and communication; how the organization functions as a citizen within the community
• Customers—customer profile and requirements on how we assess that information
• Key Business Indicators—how we select key business indicators and fulfill customer requirements
• Results—examination of near-term and longer term history of performance and how we analyze the results of performance
• Continuous Improvement—how we continually improve output, customer satisfaction and the organization
• The TACE committee gave feedback on the Medical Center’s strengths and areas of opportunity for improvement. These include:
• Strengths:
• top management support for quality
• clear definition of mission and vision
• excellent team approach
• strong communication network
• excellent planning
• very active quality improvement program

Opportunities for Improvement:

• information not always shared with front-line employees
• enhance complaint management mechanism
• communication with potential customers
• strategic plan focus on potential customers
• some goals and objectives are vague and unmeasurable
• success/failure analysis is needed for achieving goals
• Pellegrin stated that a billboard will be erected on Interstate 26 recognizing the four organizations which received the 1998 Trident Area Quality Awards. Look for it.

TACE Team Awards

• Two team projects received TACE recognition awards...the Transplant Outpaient Unit Relocation project and the Annual Reevaluation of Potential Kidney Transplant Recipients project. Kathy Turrisi, MSN, RN, program director, Transplant Center, received the awards on behalf of the Transplant Center.
• Award criteria for the TACE team award include:
• selection of project/process
• understanding existing conditions of the current project/process
• analysis of area(s) for improvement q implementation
• results
• standardization and prevention
• reflections and plans for continuous improvement

Transplant Outpatient Unit Relocation Project

• Katherine Taylor, Transplant Center financial analyst, gave an update on the Transplant Outpatient Unit Relocation Project. Others involved in this project were: Kristen Scholz, RN, MSN, CCRN; Pam Cipriano, Ph.D.; Kathy Turrisi, MSN; P.R. Rajagopalan, M.D.; Mary Anne Healy, RN, MSN; Cansas Deitz, RN, MSN; and Jennifer Schwartz.
• Taylor explained that since the Bone Marrow Transplant area had already established outpatient services through the Hope Hotel (previously located at Howard Johnson’s), the kidney program fortunately had a platform on which to build.
• The kidney/pancreas program initially created a transplant outpatient unit at Charleston Memorial Hospital (CMH). The CMH program consisted of a 7 bed unit with an RN on site 24 hours a day/7 days a week. Physicians made daily rounds and the Pharm Ds reviewed medication regimens with patients. The CMH program enabled a transition period for patients to adjust to the transplant, take their own medication and to learn to monitor their health status.
• In January 1998 the kidney/pancreas transplant outpatient unit moved from CMH to a local hotel. MUSC contracts with the hotel (Hampton Inn) to provide meals for patients and transportation to and from clinics.
• Taylor said that with relocating the kidney/pancreas transplant program to a hotel setting a concern was our nurses would no longer be present at all times. This was resolved through a cooperative arrangement with the Department of Health and Environmental Control (DHEC) to provide nursing care. Our nurse coordinators trained and inserviced the DHEC nurses regarding specific needs of patients. Currents continued from page 10
• Under the present arrangement when kidney/pancreas transplant patients are ready to move to an outpatient hotel setting a referral to DHEC is made. DHEC nurses make two trips daily to the hotel to see patients. The patients are also transported to the MUSC clinic daily to see a physician or nurse.
• Usually kidney/pancreas transplant patients are required to stay as an outpatient in the hotel setting for three to five days, unless they live in the immediate area. Following their hotel stay, patients are better prepared to go home, having been monitoring themselves with relatively little assistance by the nurses and physicians. The feedback received from patients has been very good. Annual Reevaluation of Potential Kidney Transplant Patients
• Laura Hildebrand, RN, BSN, Transplant Center nurse, reported on the Annual Reevaluation of Potential Kidney Transplant Patients TACE Award. Others involved in this project include: Pam Cipriano, Ph.D.; Kathy Turrisi, MSN; P.R. Rajagopalan, M.D.; Martin Bunke, M.D.; Milos Budisalvejic, M.D.; Joe Turner, RN, NP; and Diane Ferrara, RN, CNN.
• Hildebrand explained that before this project, there was no formal process in place to maintain contact with the potential recipients on the transplant waiting list. Hildebrand stated that due to the success of renal transplants there are a greater number of patients requesting a renal transplant and an increased waiting time for the transplants. The number of potential recipients continues to rise but the number of donors has remained steady.
• Hildebrand said they were finding that some of the patients on the waiting list have had a change in status. Of the patients that were seen for their annual reevaluation, 44 percent had a change in status requiring that they either be deleted from the waiting list or that another problem be resolved prior to transplant.
• The reevaluation process now means we’re transplanting healthier patients, the patients get a refreshed education concerning the transplant procedure, and we revisit the issue of living donation. The kidney transplant area plans to continue to reevaluate potential transplant recipients and to continue to look at data in order to create a model of who needs to be seen and on what time schedule. Performance Improvement Presentation
• Pat Kellum, RN, BSN, clinical nurse coordinator, Hollings Cancer Center Clinics, presented a performance improvement project to improve the efficiency of and accessibility to the medical records system in the Hollings Cancer Center. The performance improvement team consisted of: Alberta Mac, Jessica Logan, Myrtle Smith, Randy Harper and other UMA administrative staff.
• Kellum stated the Hollings Cancer Center increased from 1,014 patients diagnosed annually in 1993 to 1,605 patients diagnosed annually in 1997. With this volume, the medical records area needed improvements. The goals of the project were to develop a more efficient medical records system that would improve accessibility of the information in the records.
• The project focused on the following performance measures and issues with the system:
• numerous files were stored in boxes
• time required to obtain the files q time taken to file loose materials
• After checking standards used for filing medical records, they decided to expand the medical records area and move to a central location. A new filing system was installed in January 1997.
• Kellum reported that the changes made resulted in the following: Before 1692 files in boxes Time to find a file - 9 min. Time to find a file - 1 min. After 0 files in boxes Time to file loose materials - 1 month Time to file loose materials - daily
• Kellum said they now monitor the medical records system to ensure there is adequate storage space. Work is presently underway with an imaging project which will scan records in the computer system and eventually eliminate the need for record storage space.