Feb. 12, 1998

Recently, I had the privilege of representing the Medical Center at a formal presentation of our “100 Top Hospitals of 1997" award in Washington, D.C. As this is the second year we have won this recognition from HCIA Inc. and William M. Mercer Incorporated, I wanted to share with you the criteria for winning this award. Receiving the award is no small achievement, and we all can be proud. HCIA-Mercer uses a variety of benchmarks, based on information from hospitals’ fiscal year cost reports, to determine the top 100 ranking. The benchmarks selected by HCIA-Mercer include a variety of clinical, operational, and financial measures which are considered to be very important in today’s health care industry. The award is based upon the previous year’s performance—that is, the 1997 award is based upon 1996 data. This is not an award a hospital can apply for; HCIA-Mercer compiles the information independently. Each hospital’s scores for the various benchmarks are compared to the median score in its peer group, which is our case is academic medical centers of similar size. Following are the benchmarks and how we scored in 1995 (for last year’s award) and 1996 (for our most recent 1997 award) compared to the peer group median. Also, the projected figures for our 1997 performance (as best we can determine), which we believe will continue to be the basis for HCIA-Mercer’s analysis for the 1998 awards, are indicated.

FY95 MUSC FY96 FY97 Peer Group Median (FY96)

Risk-adjusted mortality index .84 .90 NA* .99

Risk-adjusted complications index (We have been below the average in these categories, which reflects well on the quality of the care we provide.) .74 .78 NA 1.08

Severity-adjusted average length of stay (We are a full day below the median average among our peers.) 4.76 days 4.24 days NA 5.27 days

Expense per adjusted discharge (This is an area where we need to continue to improve.) $9,590 $7,003 $6,991 $5,522

Profitability (cash flow margin) 12.03% 17.84% 18.38% 10.56%

Proportion of revenue from outpatient activity (Higher percentages in this category reflect sound planning in today’s market.) 19.86% 22.56% 25.9% 25.54%

Growth in outpatient revenue over three years 12.47% 12.8% 18.77% 5.91%

Index of total facility occupancy (For those who struggle daily with a bed shortage at the Medical Center, this percentage may seem low. However, this figure includes the total number of licensed beds in the facility. In Physical Medicine, Nursery and Psychiatry, a number of licensed beds are not in operation.) 70.57% 69.47% 69.38% 71.55%

Growth in facility occupancy rate 4.09% 1.56% .85% 1.78%

Growth in equity over three years (We experienced a high rate of growth for a number of years. This has begun to stabilize.) 38.54% 38.33% 15.63% 10.17%

Productivity (total asset turnover ratio)(This area reflects how efficiently assets are used. We are improving in this area.) 1.58 1.61 .96 .84

*Not yet available

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

Cool Heads Prevail in Real-Life ER Drama

• Recently in Emergency Services, a patient who was in the custody of a correctional agency somehow managed to get control of his guard’s gun and used it to shoot the officer. The prisoner was immediately subdued and no harm came to any staff members, patients or visitors. The wounded officer was admitted and given appropriate medical attention.
• Pam Cipriano, Ph.D., R.N., administrator of Clinical Services, recognized the employees for their outstanding efforts that day in helping to ensure the safety of others during and after the incident. She said that all acted coolly and calmly, following all the correct procedures for such an emergency. Susan Pletcher, director of Critical Care and Emergency Services, added that she was impressed at how everyone pulled together as a team and made the system work.
• Emergency Services: Jeff Bassett, R.N., Lorie Cannon, R.N., Sharon Macon, R.N., Carol Osmer, R.N., Doris Smalls, Francis Tunney, M.D., Dean Westmoreland, EDT, and David White, EDT.
• Outpatient Registration: Val Erwin and Cameisha McFaddin.
• Housekeeping: Sarah Brown and Gloria Rhodes.
• Security: Val Bennett, John Campbell, James Ferris, Chris Gadsden, Warren Sholl, Scott Wetzig.
• Hospital Services: Maureen Decker, R.N., Hospital Services Coordinator. Called in to debrief staff members and offer support were Karen Stanley, R.N., a psychiatric liaison nurse, and Joseph Zealburg, M.D., of the Mobile Crisis Unit. In addition Mary Anderson, R.N., and Rick Welch, R.N. from Emergency Services and Paul Moss from Safety and Security came in from home to provide support and direction to the staff.
• Al Nesmith, director of Safety, Security and Volunteer Services, said that an internal investigation into the event is under way to learn more about what happened, how it happened and what steps might be taken to further reduce the risk of such events happening.

Quarterly AREA Award Winners Announced

• Administrative resident Katrina Nell presented awards to four employees who received the quarterly AREA Award. Each quarter, members of the APPLAUSE committee review the entries of APPLAUSE Award winners and select up to five quarterly winners. Nell explained that winners must have demonstrated actions above and beyond the scope of the Medical Center’s values of accountability, respect, excellence and adaptability.

Sylvia Crews, 10 East. Crews took a patient’s clothes to her own home and washed them, since the patient’s family was from out of town and unable to. She also offered to wash the clothes weekly until the patient was discharged.

Eric Larsen and Alan Phillips, MEDUCARE. Larsen and Phillips arranged for an MUSC ambulance to be at the Reindeer Run on Kiawah Island as a public relations gesture. At the event, a runner suffered cardiac arrest. Larsen and Phillips were able to successfully resuscitate the runner at the scene through their quick and professional actions.

Georgette “Gigi” Smith, Clinical Neurophysiology Services. Smith was recognized by a patient’s parents when she arranged for the special needs of the patient. The family was traveling to MUSC from Utah for a consultation. Smith spent many hours coordinating the workup, Child Life support and hotel accommodations, and made many calls to answer the family’s questions about their child’s medical problem. Smith often worked outside of regular hours to accommodate the time difference between Utah and Charleston. The family said that without her help, their trip would have been unbearable.

• Each person received a plaque and a gift certificate, and their names will be placed on the AREA Award board located outside the cafeteria.

Call Boxes Make Appearance on Campus

• Lt. Bob Waite, Department of Public Safety, gave an update on the progress of installing emergency call boxes on campus. Waite said that the project began over a year ago when employees were asked to give suggestions on where call boxes might be needed. A campus map was distributed with Currents, and the request for input netted 100 responses.
• Sixteen boxes were installed before the holidays and more are being installed now which will bring the total number of boxes to 55. The orange boxes, marked by blue lights, are widely distributed on campus. Waite said security cameras are also being considered for some locations.
• Waite said using the boxes, which use a radio frequency rather than a phone line, is simple. If you need help from Public Safety, press the button on the call box and release it. This alerts the Public Safety dispatcher and identifies your location. When the dispatcher responds, you can talk into the speaker on the box to explain your situation. However, even if you are unable to speak, a Public Safety officer will be dispatched to your location.