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Currents Reduced reimbursement resulting from the 1997 Balanced Budget Act (BBA) and increasing levels of indigent care have made for a challenging situation at the Medical Center. We have a lot of work to do to further improve our budgetary outlook.   Charleston Memorial Hospital's budgetary situation is not good. CMH was hit particularly hard by the BBA reductions. Also, CMH appears to have a relatively high staffing level in certain areas for the service demand. To address CMH's budgetary and staffing issues, we plan to reassign some CMH employees to suitable roles within the Medical Center. The process of reassigning employees will require careful attention by the entire management team. Working together, we will be able to align resources to meet service needs, and everyone will benefit.   W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center Keating outlines pros, cons of MUSC's Y2K preparedness Tom Keating, administrator for the Children's Healthcare System, thanked a number of Medical Center and university employees for their work in preparing for Y2K. Keating outlined the following pros and cons of MUSC's Y2K preparedness: Pros:  Updated the medical equipment system Validated and upgraded emergency power back-ups Verified vendor support arrangements Replaced and updated many of our patient monitoring systems Practiced our internal disaster plans Cons: Slowed down the Emerald roll-out Spent hundreds of hours in Y2K-related readiness Diverted management's attention College of Health Professions Danielle Ripich, Ph.D., professor and dean of the College of Health Professions, updated the management team about the college, which is the largest college at MUSC. The College of Health Professions includes 800 students in 14 programs, which range from bachelor's-level to an executive doctorate in health administration. Ripich emphasized the college's strength in educational programs. Students achieve a 98 percent exam pass rate. Ripich would like to expand the college's clinical outreach and applied clinical research.  Within the past year, the college increased its extramural funding by 244 percent.   ClinLAN Plan David Northrup, director of CCIT Healthcare Computing Services, and Bill Rust, manager of Healthcare Network Services, announced that CCIT is working with Novell Inc. to implement a new plan for ClinLAN log-in processing. Recently, ClinLAN users experienced slow log-ins and a network outage. The new approach is being implemented to help ensure quick, reliable log-ins, and will allow large numbers of ClinLAN users to log in simultaneously, without affecting the speed of the log-in process. It should take between 16 and 24 weeks to implement the plan. During this period of change, problems could occur with the log-in process, but CCIT and Novell are doing everything possible to minimize and avoid these issues. Rust encourages users to have patience during the log-in process if the slowness issue occurs again.  Users also can access their "downtime icons," which will link them to essential patient care information and software programs. Visit the ClinLAN web site for more information (http://clinlan.musc.edu). If you have questions or would like a CCIT representative to talk with your staff members, contact Northrup at 792-6675 or Rust at 792-3403.  New Grievance Policy Susan Carullo, manager of Medical Center Employment, Compensation and Employee Relations, discussed key elements of the authority grievance procedure, which was recently approved by the State Budget and Control Board. This new procedure will go into effect with the implementation of the Medical University Hospital Authority, which is planned for July 1. Frequently, employees' concerns are resolved prior to any formal grievance process, but the grievance procedure serves as a safeguard to ensure the resolution of grievable matters in a timely fashion. The Me Issues Committee helped develop the procedure. The goal was to develop a policy substantially similar to the state's policy, but to streamline it for prompt resolution of grievances. The MUSC board of trustees and the State Budget and Control Board approved the new procedure. Approximately 18 employees from all areas of the Medical Center will be trained in methods to conduct the grievance procedure. A panel of three trained employees will be selected to consider a grievance. Adverse actions, including suspension, loss in pay or termination are grievable. Employees who do not wish to resolve concerns through the formal grievance procedure, or who have issues not subject to the formal grievance process, may address concerns through a mediation/conflict resolution process. For suspension or other loss in pay, the panel will conduct a document review. The employee and/or his or her representative will verify the documentation and add comments as necessary. The panel will conduct a hearing for terminations. The employee, if desired, may be represented by counsel. The grievance panel will make the decision on behalf of the Medical Center to uphold the adverse action (taken against the grievant/employee), modify or overturn it.   The vice president for clinical operations and executive director of the Medical Center will not override the panel's decision to overturn or modify an adverse action. The grievant, if dissatisfied with the panel's decision to uphold an adverse action, may appeal to the vice president for clinical operations and executive director of the Medical Center, who will conduct a review of the record and notify the grievant of the final decision. The new grievance procedure will be included in a future brochure. Anyone who would like a copy of the new procedure at this time should contact Jane Smith at 792-4120 or via e-mail (smithjan). Customer Service Work Group Joan Herbert, administrator for the MUSC Institute of Psychiatry, reviewed the goals and initial work of the customer service tactical planning work group. Improving customer service is one of five tactical initiatives related to MUSC's clinical strategic plan.  Two of those initiatives, customer service and reducing costs (also known as "c-squared"), have been selected as the Medical Center's priorities for performance improvement this year. The overall goal of the work group is to create a plan for achieving a level of customer service at MUSC in which each employee demonstrates our core values—accountability, respect, excellence and adaptability—in every interaction with patients and their families. The work group outlined the following key task areas to develop the customer service tactical plan: Create a behaviorally specific description of customer service Conduct a management survey Conduct an organizational policy review Develop a video for orientation Create a self-guided training CD-ROM Develop a monitoring/feedback system Link with Human Resources Create an implementation plan