MUHA unveils aggressive plan for improvementWith a goal to improve communication within the medical center, administrators conducted town hall meetings last week, presenting the Medical University Hospital Authority’s Tactical Plan for improvement.In three sessions scheduled to allow for varying work constraints, administrators detailed plans in five areas of focus: financial performance, provider of choice (patient satisfaction), employer of choice (staff satisfaction), quality and safety, and information management. “It’s quite a challenge in an organization of about 4,500 people to make sure everybody feels like they are in the loop,” said W. Stuart Smith, vice president for operations and executive director of the MUSC Medical Center. Presenting an overview of the tactical plan, Institute of Psychiatry administrator Joan Herbert, who serves as tactical plan coordinator, said a plan was “pulled together over the past year that’s really focused on ‘How do we get the medical center to be the very best that it can be in five key areas?’ For us to reach the targets that we’re shooting for, we need the help of every single individual in the medical center.” Medical center’s goal for financial performance would achieve incremental increases in financial margin to include 3.5 percent in fiscal year 2005, 4.0 percent in 2006 and 5.0 percent in 2007. Herbert said in the health care market it is commonly accepted that an institution has to have a 5-percent margin to have enough cash to sustain itself. With an eye to reducing expense in the organization, Herbert said efforts are under way to examine clinical efficiencies, recycle products, not use specialty beds when they are not absolutely needed to take care of patients, and other things that can be done on a day-to-day basis to reduce expense. “We’re also looking at utilization management and what kinds of resources we can use to make sure that we’re using what we need to take care of patients, and to make sure we’re not misusing things excessively when we don’t need to,” she said. She also spoke to managerial controls. Being provider of choice, Herbert said, means that when somebody thinks of health care, “We want them to think of MUSC first.” She said that has to do with quality of care and patient satisfaction with that quality of care. A patient satisfaction survey targets two questions to set goals on: Overall quality of services with a goal of 93.7, and would you recommend? with a goal set at 76.1. As an employer of choice, the MUSC Medical Center would reduce overall turnover of permanent positions from 12 percent to 11 percent and reduce overall turnover of permanent core registered nurse positions from 15 percent to 13 percent. “We can’t deliver high-quality care with a high level of patient satisfaction unless we have high-quality staff to deliver that care and take care of patients,” Herbert said. For quality and safety, a 90 percent compliance with Center for Medicaid and Medicare Services (CMS) measures would be achieved in community-acquired pneumonia, heart failure, surgical infection and acute myocardial infarction. A second quality and safety goal would achieve 90 percent compliance with evidence-based practice for prophylaxis of DVT/PE, post-op UTI, post-op pneumonia, post-op AMI, pressure sores and post-op sepsis. Information management goals would be to implement an employee satisfaction assessment process during the 2004 fiscal year and create a projected time line for vendor selection, contract negotiations and subsequent implementation schedule. Helena Bastian, director of MUSC Medical Center Human Resources, outlined the Pilot Incentive Pay Plan portion of the overall tactical plan, which places emphasis on designated core organizational goals to include the tactical plan’s financial target and patient satisfaction elements and cash awards to employees if predetermined goals are met by fiscal year 2004-05. The incentive plan would reduce cost and improve the medical center’s operating margin by offering 1 percent of an eligible employee’s annualized base pay rate or $250, whichever is greater. Eligible temporary employees may receive 1 percent of their base pay rate, not to exceed $350. The incentive pay would hinge on meeting the financial, patient- satisfaction and quality-of-care targets of the tactical plan, namely: 3.5 percent operating margin, the patient satisfaction survey’s 93.7 overall quality of care/services, and 76.1 “Would you recommend?” Details on the Incentive Pay Plan and eligibility requirements are on the Human Resources Web site under policies, number 15, Bastian said. Rosemary Ellis, director of quality and patient safety, told those gathered for the town meeting that patient satisfaction, which measures the quality-of-care and would you recommend?, is important. “If a patient has a good experience here, they will go out and tell five other people. If they have a bad experience here, they will go out and tell 10 or more other people,” Ellis said. “Those of you who have had bad experiences in other areas of your life, whether at a department store or at a cleaner, keep in mind how you would go out and tell people how you were treated, and that’s the same for patient satisfaction,” she said. Another reason, Ellis said, within the next two years patient experience of care will be posted to the Web just like quality of care and CMS indicators are posted on the Web. The information will be available for everyone. She said that patient satisfaction information will be sent out monthly
to give managers and employees a running update of patient satisfaction
progress.
Friday, Sept. 24, 2004
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