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Currents Approximately six months ago, MUSC began laying groundwork for a new organizational structure for MUSC Children’s Hospital referred to as the “Clinical Services Unit Model.” This initiative was launched by Jerry Reves, M.D., vice president for Medical Affairs and dean, College of Medicine, upon his arrival at MUSC. The Clinical Services Unit Model, which is a form of product line management, is intended to bring together clinical and administrative leaders to oversee the strategic planning, clinical performance, business development and financial management of Children’s Hospital. Two individuals will assume new responsibilities with this initiative. Phil Saul, M.D., will serve as Children’s Hospital medical director and Dave Neff, administrator, Ambulatory Care Services, will assume an additional role as interim administrator for Children’s Hospital. We will recruit for a permanent administrator. These individuals will be accountable to Lyndon Key, M.D., chairman of pediatrics, Dr. Reves and to me for the clinical, operational and financial performance of Children’s Hospital. I am optimistic that this new Clinical Services Unit Model will enhance patient service and care and will strengthen the financial performance of Children’s Hospital. Please join me in welcoming Dr. Saul and Mr. Neff to these new roles. W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center   Detailed inventory process to begin for Medical Center MUSC Medical Center will soon conduct a system-wide detailed property inventory. The property inventory will have a direct effect to our bottom line and everyone’s cooperation is needed, according to the Medical Center Chief Financial Officer Lisa Montgomery who announced the plan at the Jan. 12 communications meeting. The property verification process will be the responsibility of the business manager in clinical departments and the office manager in non-clinical departments, and needs to be completed by the end of March. Mitzi Fetner, accounting manager for Physical Asset Management/Project Administration, said every effort is being made to streamline the process. “We want to make the future very friendly for you and your inventory,” she said. Inventories are being sought for items valued at $1,000 and more for both capitalized and non-capitalized property. This level mirrors the University’s starting point as was suggested by our auditors, according to Dan Altman, program coordinator, Technology Assessment. Clinical areas can contact Biomedical Engineering (792-3984) to request a Biomed listing report on patient care related equipment for use as an added resource in this process. Fetner said the inventories need to be recorded in Excel spreadsheet format using the property management database. She urged managers to contact her office at 792-3080 or 792-3081 for verification tips and to answer any questions that may arise in the course of gathering inventories. “If you’re in doubt, put it on the list and we’ll sort through it,” Altman said. Injury prevention shows significant reduction in exposures The Medical University Hospital Authority offers a variety of injury prevention initiatives, with a key emphasis in recent years on injury prevention and injury reduction in the workplace. Mary Allen, program coordinator, was recently appointed as the chair of the Injury Review and Recommendation Subcommittee, presented the findings to the management team. The Injury Review and Recommendation group is a subcommittee of the Environment of Care Committee. Allen pointed out the difference between an accident and an incident. “An accident implies an unforeseen, unavoidable situation,” she said. “Most injuries are predictable and preventable.” Past or present members of this subcommittee are Leo Albano, Mary Allen, Joe Avant, Debra Bean, Ann Benton, Cheryl Brian, Cindy Brown, Barbara Burke, Michael Fredrick, Betty Harley, Jodell Johnson, Al Nesmith, Margie Petko, Nancy Pope, Erica Rouvalis, Mary Santana, Nancy Sifford, and Laurie Zone-Smith, past chair. One significant initiative is the Bloodborne Pathogen Program, managed by the MUSC Occupational Safety and Health Program coordinator, Cheryl Brian. This program is monitored by the injury review group and has had a 36 percent overall reduction in employee exposures from 1999 to 2001. Since 1999, straight needle injuries have been reduced by 40 percent and IV catheter injuries have been reduced by 80 percent. These reductions are attributed to availability and use of safety devices, needle-less systems, use of personal protective equipment and increased employee education concerning bloodborne pathogen exposures. The product evaluation coordinator, the BBP coordinator and infection control practitioners have been instrumental in promotion of safety device use. Injury, performance improvement initiatives Examples of initiatives undertaken to help reduce the number of employee injuries at the Medical Center are as follows: Bloodborne Pathogen Exposure Program, which implemented training programs for use of safety devices and reinforcement of BBP training and education. Adjustment of needle box heights is under way as recommended by NIOSH;  Musculoskeletal (MSD) injury monitoring; Back injury monitoring and awareness, which has resulted in a 33 percent reduction of injuries; Ergonomic initiatives; Work site evaluations. Other performance improvement efforts include: Implementation of the Medical Center lift team. The Lift Team, initiated in March 2001 has performed 1,771 patient lifts and transfers, with an average of 41 lifts per week and an average response time of 4-5 minutes. To introduce the lift team, an awareness campaign was conducted that included lift team participation in unit meetings; One-time courtesy evaluation from (PT) for injured employees referred by MUSC Employee Health Services; Work site evaluations for current employees; Employee slip/fall risk reduction measures; Promotion of safety device usage; Resolution of environmental hazards; and Emphasis on training. According to Erica Rouvalis, Physical Therapy manager, the PT evaluation offer has made a significant difference in minimizing injuries once they occur. The service provides follow up and education for 7 - 10 days to employees injured on the job, including guidance on proper positioning, use of ice and heat treatments, range of motion exercises and management of inflammation. In 2001, some 60 courtesy visits were conducted. Rouvalis stated the employee program has saved the Hospital Authority money by reducing the number of Workers’ Compensation claims. Of the 60 visits, only 20 turned into Worker’s Compensation claims, she said. The others were managed by employee health and PT. Joe Avant, director of MUSC Occupational Safety and Health Programs, indicated that we have received awards for injury reduction for the last two consecutive years. He urged departments to consider offering ergonomic features to employees to help prevent injury; such as through the use of headphones, back rests and ergonomic keyboards. “If you have an employee who is experiencing any signs or symptoms, we are available to come over and give an evaluation,” Avant said.   To request a work site evaluation, contact Occupational Safety and Health at 792-3604. Fire safety issues On a final note, Joe Avant gave a slide presentation on common fire and life safety violations noted during a recent inspection.  Everyone is encouraged to ensure that the hallways are not used for storage of any kind, including linen bags. Also, no doors should be propped or wedged in the open position. “We are doing a good job of keeping oxygen cylinders in Mayday carts uncovered, as requested by DHEC,” he said. “We need to do a better job of securing medical gas cylinders at all times to prevent injury. These conditions are in violation of fire safety codes.” Policy development, review process updated The Medical Center Policy Management Committee gave an update of its procedures regarding the standardize process for the development, review and approval of policies listed in the Medical Center Policy Manual  (administrative and clinical policies).  According to Rosemary Ellis, director of quality, all new policies and proposed changes to existing policies must be forwarded to the Policy Management Committee utilizing the “Request for Policy Development, Review and/or Revision” form. Prior to forwarding policies to the Policy Management Committee, however, the individual coordinating the review is responsible for assuring the policies are reviewed by representatives of involved disciplines.  The Policy Management committee will facilitate the progress through Legal, JCAHO Steering Committee, Administrative Operation’s Committee and, finally, the Medical Executive Committee. Once the process is complete, the new or revised policy will be disseminated to employees. Check the Medical Center Intranet for a copy of the request form and to view all policies, including most recent revisions and additions.