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Currents To Medical Center employees: The Medical Center management team enjoyed hearing Jerry Reves, M.D., vice president for Medical Affairs and dean, College of Medicine, speak at the Oct. 16 communications meeting. It was Dr. Reves’ first presentation to the entire management team since his appointment officially began in July 2001. Dr. Reves was complimentary of the Medical Center management team and staff.  His comments are highlighted in this newsletter. While the Medical Center works with all of MUSC’s colleges toward fulfilling our mission, our day-to-day work is most closely intertwined with the College of Medicine. Together, the College of Medicine (including its University Medical Associates) and the Medical Center comprise the clinical enterprise. We must always be mindful that the Medical Center's primary means of fulfilling our patient care mission is through the work of clinical faculty. At times the clinical faculty has expressed concern over the Medical Center management team’s responsiveness—or lack thereof—to their needs.  Now is a good time to renew our commitment to a close and cooperative working relationship with the clinical faculty.  Some measures have been taken to do a better job in seeking guidance and in strengthening communication on matters such as facilities planning, equipment purchases, nursing services, performance improvement, JCAHO standards, customer service and other issues. As we move forward, the Medical Center management team will continue to look for ways to strengthen our working relationships for the benefit of all concerned parties. Thank you very much. W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center   Dean addresses management team, shares vision Addressing the management team for the first time since assuming the position of vice president for Medical Affairs and dean of the College of Medicine, Jerry Reves, M.D., spoke highly of the administration’s team approach.   “It is gratifying to work with an administrator who views administration, nursing and faculty as one team,” he said, referring to Stuart Smith, vice president for Clinical Operations and executive director of the Medical Center. Reves pointed to that commitment to a team approach and to the growth of interdisciplinary programs that bring basic scientists and clinicians together as compelling factors in his decision to return to MUSC.   Reves, who officially began as dean in July, is a Charleston native and attended medical school here, graduating in 1969. Reves came to MUSC from Duke University where he served as professor and chairman of the Department of Anesthesiology since 1991. During his career at Duke, which began in 1984, he also served as director of cardiotho-racic anesthesia and director of the Duke Heart Center. Earlier in his career, he was a member of the training staff at the National Naval Medical Center in Bethesda, Maryland, and professor of anesthesiology at the University of Alabama at Birmingham. Reves has been touted as a respected clinician, teacher, researcher and administrator.   Reves cited recent accomplishments of MUSC as indicative of the long-term future of the institution and its commitment to its clinical, educational and research mission. He gave particular note to MUSC being named as one of the top 10 children’s hospitals in America by Child magazine and as number 17 in the country in the volume of solid organ transplantations, along with MUSC's standing as the only multi-faceted transplant facility in the state. Reves also announced that MUSC is the recipient of a significant national award to be revealed to the public on Nov. 2.   Giving an historical perspective, Reves noted that the School of Medicine began in 1824 with four faculty. “We now have 800 faculty, six clinical and eight basic science programs, and 140 medical students per year,” he said. Even though 90 percent of the students must be residents of South Carolina, many of the medical students attended colleges out of state, which helps to enrich the perspective they bring, he added.   Reves commended the management team for handling so well the $76 million in budget cuts that resulted from the Balanced Budget Act. “Your commitment to the teaching and clinical care missions has been incredible despite the Balanced Budget Act,” he said.   Reves cited the following as areas of focus for the College of Medicine: Development and creation of successful interdisciplinary programs, especially in the areas of cancer, cardiovascular disease, children's and women’s health, neuroscience and aging.  Creation of an environment that fosters and supports the collaborative interaction of basic scientists with clinicians Reduce dependence on the Ambulatory Care Agreementand try to get back to capital levels prior to the Balanced Budget Act Work with John Heffner, M.D., medical director, (see related article this page) to reduce expenditures through the Management Resource Plan Work with Mark Lyles, M.D., associate dean for Clinical Operations, College of Medicine, to adjust the payer mix. “I feel it’s our responsibility to provide care for everyone,” Reves said, “but MUSC should not be the only place (in South Carolina) to provide care for unsupported patients.” Increase surgical services Develop clinical information systems. “Hopefully, we will be a major player in that,” he said. Develop Department of Radiology Improve outcomes-based clinical research Rededicate MUSC to be patient-centered, with an emphasis on patient care and patient satisfaction “Fundamentally, we're going to focus on the health of the citizens of South Carolina,” Reves concluded. “I think we’ll be tremendously proud. I look forward to working with you in the coming days and years.” Medical director describes Center for Clinical Effectiveness  Since April, John Heffner, M.D., medical director, has been working with the administrative team in an effort to integrate resources. “My role is an interface between the clinical and administrative components of the institution,” he said. “When faced with increased market pressures, things can fly apart,” Heffner said, indicating that MUSC has taken a preemptive approach by formulating the MUSC Center for Clinical Effectiveness that focuses on quality management, risk management and outcomes management. One of the developments as a result of this new effort is the on-line clinical order forms. “This will be more time-efficient,” he said. He also indicated that among other improvements an effort is under way to set up electronic medical records. Medical Center shows revenues in the black The management team was given an update on the financial status of the Medical Center by Lisa Montgomery, administrator, Finance and Support Services; Ralph Greene, director, Hospital Fiscal Services; and John Cooper, director, Finance. Greene indicated that the Medical Center shows year-to-date revenues over expenses of $2.2 million. “The major issue with the Hospital Authority is its ability to generate cash,” Greene said. “The good news is we do have a positive line to the tune of about $2.2 million.” Greene indicated that the Medical Center's cash flow problems are mitigated by lines of credit made available to it by banks and through disproportionate-share revenue that comes from the federal government. The federal funds are set up to compensate medical centers such as MUSC that service a disproportionately high share of indigent patients.