Jan. 29, 1998

Our strategic plan of 1993 included several goals relating to improving our infrastructure. We defined our infrastructure as information systems, operating systems (such as parking and patient scheduling) and facilities. A year ago we received approval from the MUSC Board of Trustees to proceed with about $63 million worth of improvements to our facilities and information systems. Some of these projects have been completed or are under way, while many are still being planned.

At the Jan. 27 meeting of our medical staff, I presented a list of construction and equipment projects we are working on as part of a three-year plan to reinvest the dollars generated by the Medical Center.

These improvements to the hospital and their estimated costs include:

• Medical University Hospital air conditioning upgrades—$3.5 million
• Medical University Hospital crawl space improvements, such as paving the area under the east side of the hospital—$2 million
• MUSC Children’s Hospital air conditioning upgrades—$2.3 million
• Paging system upgrade—$1.4 million
• Medical air system replacement—$225,000
• Medical University Hospital fire alarm upgrade—$225,000
• Morgue improvements, especially in air handling—$1 million
• Medical University Hospital Emergency Services Department expansion—$7 million
• Operating rooms expansion, including six new rooms on the fourth floor—$6.4 million
• Medical University Hospital fourth floor ICU aesthetic improvements (which will be followed by general renovation after the operating rooms project is complete)—$2.4 million
• MUSC Children’s Hospital exterior skin improvements—$3 million
• Bed and television replacements—$4.8 million
• Replacement of corridor flooring—$2.3 million

These improvements, along with the opening of MUSC Rutledge Tower, will help us improve patient care in many ways and will help us more effectively handle the capacity problems we currently face.

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

Announcements

• John Cooper, director of Finance, distributed budget packets for the 1998-1999 fiscal year to the management team. These packets also were distributed via E-mail. The personnel, operations and renovation forms included in the packet must be returned to the Finance office by Feb. 20 in order to meet the university’s timetable. Highlights of the 1999 proposed budget include:
• Activity—Admissions are projected to increase by 3 percent, patient days by 2 percent and outpatient visits by 8 percent.
• Personnel—Salary expenses and full-time equivalent positions, or FTEs, are budgeted in the current manner with no increases in numbers. Salaries will be adjusted for state-mandated increases when that information becomes available.
• Revenue—Net disproportionate share, the money paid to the Medical Center because of the amount of care it provides to indigent patients, will be reduced by $2 million to $49 million.
• Lauren Jones, Ph.D., has been employed in a temporary position to address employee development issues. Jones will be conducting focus groups made up of employees beginning next week. These group meetings will be held in the 2 West Classroom and will give employees a chance to offer their views on what is working at the Medical Center and what is not working. All information shared will be used to improve our workplace and identities of participants will be kept confidential. Refreshments will be served.

Schedule: Sunday, Feb. 1, 4 - 5 p.m. and 8 - 9 p.m.; Monday, Feb. 2, 10 - 11 a.m., 4 - 5 p.m. and 8 - 9 p.m.; Tuesday, Feb. 3, 3 - 4 a.m.

• The MUSC Board of Trustees will be meeting Feb. 12 and 13. A full agenda, including several requests for capital expenditures, will be presented.

Recognition

• For the first time in several years, our transcription services provider reported a “zero” backlog in operative reports and discharge summaries. Brenda Bailey, manager of record maintenance, and Krissa Jackowski, accepted a round of applause on behalf of Health Information Services.
• Jodell Johnson, manager of Quality Improvement, was elected treasurer of the South Carolina Association of Practitioners in Infection Control.
• Outcomes managers Mary Wilbur and Hazel Huff received a $15,000 grant to fund a cancer fatigue awareness campaign. Beginning in the fall, the campaign will include public symposiums and community awareness messages in the media. It will conclude at the annual Camp Bluebird for cancer survivors.
• Pam Cipriano, Ph.D., R.N., has written a chapter for the book “Nursing Student to Nursing Leader: The Critical Path to Leadership Development,” which will be released in April. Her chapter is entitled “Interdisciplinary Socialization.”

Medical Center Performance

• Tom Keating, administrator for Finance and Support Services, updated the management team on several performance indicators tracked at the Medical Center. He noted that activity levels continue to be strong, defying what is happening at hospitals elsewhere in the country. A number of factors have helped us maintain this performance, including promotion of services, additional faculty and our affiliation with the primary care network of Carolina Family Care. He also said that while our inpatient expenses per admission compare fairly well with other academic medical centers, we are still higher than community hospitals and we must continue to work to improve our efficiency.
• Keating also announced that the delinquency rate for overdue performance evaluations was at approximately 12.2 percent in December 1997, and this is a matter that needs attention.
• On a more positive note, Keating revealed the University HealthSystem Consortium/Picker Institute patient satisfaction survey results. The percentage of adult patients rating the Medical Center as “excellent” overall was 44 percent, compared to an average of 39 percent for UHC members. For pediatric patients, the rating was 48 percent compared to an average score of 41 percent in the UHC. Also, UHC/Picker Institute data indicated that the number of patients who would definitely recommend MUSC to their family and friends was 77 percent for adult and 83 percent for pediatric patients. These percentages compare favorably with UHC/Picker Institute statistics of 72 percent and 70 percent respectively.

Activity Levels (July - December 1997)

Budget 1998:

• Patient days-- 78,016
• Admissions--13,518
• Outpatient visits--243,304

Actual 1998:

• Patient days--78,454
• Admissions-- 13,501
• Outpatient visits -244,432

Financial Performance (July - December 1997)

Budget 1998:

• Operating cash reserves 72 days 53 days
• Inpatient expense per admin $9,725 $9,589
• Net income (bottom line) $1,065,950 $516,371

Actual 1998