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March 16, 1999

Currently, legislation is under consideration to enable the MUSC Medical Center to change its governance structure by forming a state public authority. This change would be in line with our strategic plan and the KPMG consulting firm's recommendation. The goal would be to achieve increased flexibility in management and operations while continuing as a state entity.

Under the legislation, our Board of Trustees would remain intact. The board would essentially wear two hats as the governing board for both the university (academic division) and the authority (hospitals and clinics). As an authority, the Medical Center would be exempt from state procurement, construction and human resources regulations, and generally would have increased autonomy.

If passed, the legislation would enable the Medical Center to create its own industry-aligned procurement plan for approval by the state Budget and Control Board. We would have greater flexibility with capital improvement projects.

From a human resources perspective, we would be able remain in the state retirement and insurance plans, which is a key issue for many employees. We would be exempt from the various human resources regulations concerning leave, compensation and grievance. As written, the legislation would enable the Medical Center to design its own human resources policies. We plan to seek widespread input and resurrect the “Me Issues Committee” to address human resources needs.

As communicated in previous Currents, we hope to work toward implementing an industry-aligned paid time off, or PTO, plan that recognizes service and seniority, and consolidates annual, sick, holiday and other leave in some fashion. Our goal is to protect the annual and sick leave that employees have accrued under our current system. We believe a PTO plan will enable a more equitable leave plan, reward exceptional attendance and hopefully offer cash incentives.

We are committed to protecting employees' compensation. Under the authority, we hope to continue our efforts toward competitive and performance-based compensation, including incentive plans. Ultimately, our compensation plan will be linked to the Medical Center's overall performance.

The legislation enables the Medical Center to create its own grievance program. Our grievance plan will be filed with the Budget and Control Board. We expect to assess grievance plans at other leading academic medical centers and develop a plan that ensures fairness and the best interests of all concerned parties.

The legislation was recently introduced, and it will take a significant period of time before all the issues are resolved. From our previous experience, we are well attuned to employees' areas of interest. We will communicate extensively as we move forward.

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

AREA/APPLAUSE Awards

• Marc Williams, manager of Clinical Neurophysiology Services and chair of the AREA/APPLAUSE Awards Committee, presented the AREA/APPLAUSE awards for the first quarter of 1999. These individuals received a plaque and a mall gift certificate. Their names will be added to a plaque outside the cafeteria.
• Lynn Uber, Pharmacy. A kidney patient was very depressed because she was losing her kidney. The patient's father was afraid to leave her in order to pick up newly prescribed medicine. Uber picked up the medicine and delivered it to the patient at her hotel. Uber went out of her way to help the patient and her family during a stressful time.
• Jean Smith, Respiratory Therapy. Smith loaned her personal furniture and appliances to a patient's family for three-and-a-half months in order to help them get settled in an apartment during their stay in Charleston. Smith was recognized for going the extra mile.
• Andrew Atkinson, R.N., Youth Star Program, Institute of Psychiatry. A family whose child accidentally threw her dental retainer in the trash recognized Atkinson for his assistance. When it was discovered the trash had already been taken to the dumpster, Atkinson searched the dumpster and retrieved the retainer. The family was very happy and relieved they didn't have to replace the retainer.
• John Martin and Trey Clark, 1 West. Martin and Clark were recognized for the exceptional job they did cleaning up a patient on Thanksgiving.

Medical Surveillance Requirements

• Joe Avant, director of Occupational Safety and Health, reported on OSHA's 1998 top health care violations of concern to MUSC. He indicated that MUSC is in good shape for most of these areas, but some improvements are needed. The top violations include the following:
• Failure to maintain accurate chemical inventories, material safety data sheets and labeling of secondary containers.
• Failure to maintain the OSHA 200 log: ACORD forms, monthly summary, annual log.
• Failure to supply and test eyewash stations and emergency showers. Avant said OSHA standards have changed to include more frequent testing. MUSC Occupational Safety and Health staff are developing a new testing schedule to ensure compliance.
• Failure to guard machines, which only applies to Occupational Therapy and Hospital Maintenance.
• Failure to maintain and enforce a bloodborne pathogen exposure control plan. Avant indicated this area needs some work. According to Avant, approximately 60 percent of exposures could have been prevented if the bloodborne pathogen exposure control plan had been followed. A recommendation for future violations suggests that a letter should be sent to an employee's supervisor requesting disciplinary action for failure to comply with the policy. The policy is outlined in both the human resources management manual and the OSHA manual.
• Failure to provide bloodborne pathogen training.
• Failure to make Hepatitis B vaccines available.
• Failure to comply with OSHA's personal protective equipment standard, or PPE:
• Each area must determine which employees are at risk.
• For at-risk employees, PPE must be made available and used to perform duties.
• Avant said all duties that require PPE must be identified, with the required PPE listed for each duty. If managers need assistance, please call 792-3604.

ACORD Form Performance Improvement Project

• Cheryl Brian-Buse, R.N., BSN, program nurse specialist for Occupational Safety and Health, and Nancy Sifford, R.N., manager of Workers' Compensation, presented information about the performance improvement project for the ACORD form.The ACORD form is the first report of injury form used to document occupational injury or exposure. They found that managers and employees often fail to submit a completed ACORD form following an injury or exposure, which results in inaccurate billing, inaccurate OSHA reporting and a delay in workers' compensation benefits.
• Sifford reviewed the form and explained the proper procedure for reporting an injury or exposure.
• Improvements will be measured by comparing ACORD forms reviewed in August, September and October of 1998 with forms submitted during June, July and August 1999. The variations will be reported to the Hospital Injuries Review and Recommendation Committee and the Environment of Care Committee, and shared at a future communications meeting.