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Town Hall Meeting Patient satisfaction goals, survey briefed Stuart Smith, vice president for operations and executive director of the MUSC Medical Center welcomed the audience and reviewed the 45-minute meeting agenda, which was arranged under the Five Pillars of Excellence format—service, people, quality, finance and growth.   He explained the pillars serve as the framework for communication of the Medical Center’s goals, meeting agendas and leader evaluations. He asked that all attendees complete the town hall evaluation and explained that the evaluation results measure not only the town hall meetings, but also our progress with various MUSC Excellence initiatives. The evaluation results will be summarized and disseminated in the near future. Organizational goals update What is MUSC Excellence? Smith explained that MUSC Excellence is our long-term initiative to make MUSC Medical Center a great place to work, a great place for patient care, and a great place for physicians to practice medicine. He also reported that MUSC Excellence is a way of doing business and includes implementation of a number of best practices. The Medical Center kicked off MUSC Excellence a year ago and has made good progress.   Smith reviewed the Medical Center’s current organizational goals: Service—Increase patient satisfaction (inpatient and ambulatory) to the 62nd percentile People—Reduce annualized turnover of Medical Center employees from 16 percent to 14.5 percent; increase employee satisfaction Quality—Decrease mortality index to .77 Finance—Achieve or exceed an operating margin of 5 percent; reduce FTEs per adjusted occupied bed to 6.3 (includes Ambulatory Care) Growth—Increase inpatient admissions to 2.7 percent; increase outpatient visits by 5 percent Smith explained that the Medical Center is devoting much effort to patient satisfaction measurement. The organization will continue  to educate everyone in the use of patient satisfaction survey data.   Ambulatory Care began using Press Ganey for patient satisfaction measurement about two years ago. Approximately six months ago, the Medical Center’s changed its patient satisfaction survey vendor for inpatient services to Press Ganey to enable Medical Centerwide consistency and promote understanding. The hospital now has two full quarters of inpatient satisfaction data.   Smith explained that Press Ganey has around 1,500 hospitals in its patient satisfaction database including around 120 academic medical centers. Patient satisfaction data is reported by mean scores and percentiles and this enables comparisons with other hospitals. When the Medical Center’s results are compared to other academic medical centers, MUSC compares much more favorably than to smaller non-academic hospitals. However, for purposes of goal setting, the organization is comparing themselves against other similarly-sized (non-academic) hospitals since that better represents the competition.   Smith reviewed patient satisfaction results in multiple service areas including: Adult Hospital, Ambulatory Care, and Children’s Hospital.   The Children’s Hospital demonstrated remarkable improvement in patient satisfaction scores since last July (42nd percentile) to December (77th percentile) achieving their overall goal (62nd percentile). AIDET (Acknowledge, Introduce, Duration, Explanation, Thank You) training using key words at key times was credited for enabling the substantial increase in the patient satisfaction survey results.   Smith noted the Medical Center has not made progress with its “people pillar goal” to reduce turnover, and explained the employee satisfaction portion of that goal would be discussed later.   Smith also explained the Medical Center is making good progress, as evidenced by the most recent reports, with its quality goal (mortality index of .73), finance goal (margin of 5.2 percent), and growth goal (inpatient growth at 7.3 percent and outpatient growth at 7.2 percent). However, the financial goal to reduce FTEs is not on target at 6.6, however the Medical Center's high volume of inpatients/outpatients along with the shortened length of stay may indicate a need to reassess this particular benchmark. Employee Perspectives Survey Betts Ellis, administrator for institutional relations, discussed the Employee Perspectives Survey conducted by Press Ganey in October. The results were received and hospital administration is working with Press Ganey to make some system-related improvements to enhance use of the software.   Ellis stated that the administrative team was delighted that 3,799 employees responded (67 percent of the workforce) and 4,884 narrative comments were made. Employees were able to respond anonymously to 67 questions. The survey results will enable a more detailed analysis than previous surveys including assessment by work shifts, length of service, occupational category, age category and organizational unit.   The administrative team will be meeting with the Press Ganey representative soon to review the employee perspectives survey results and for training.   Ellis stated at the Feb. 28 Leadership Development Institute (LDI) the leadership team (supervisors, managers, directors and administrators) will be given training by the Press Ganey representative on how to navigate and interpret the employee perspectives survey results. The  Studer Group lead coach, Don Dean, will train the leadership team on how to roll out the survey results to all staff and develop action plans for improvements. Leaders’ action plans will later be reported through their online leader performance evaluations as a component of their “people pillar goal.”   Ellis indicated, in regard to employee satisfaction, that a number of comments and Rumor Mill questions have been raised about the revised Personal Appearance and Dress Code policy requiring designated scrub colors for clinical areas. The administrative team has looked into this matter closely and determined that similar policies at other hospitals serve in the best interest of patients and their families and others. He reported that Marilyn Schaffner, administrator of clinical services, and Smith have asked that details be worked out to provide a lump sum check for all affected employees, with the net check being enough to cover the cost of two sets of scrubs. The effective date of the scrubs plan implementation will be moved to April 1. More details will be issued soon.   Also, Ellis reported that a number of concerns have been raised, beginning in last year’s employee satisfaction survey, about the lack of a range of after-hours food choices. Lisa Montgomery, MUSC vice president for finance and administration and Medical Center chief financial officer, and Smith have asked Dietetic Services to bring forth a plan to provide both extened late hours of operation and food choices to support employees working on alternative shifts. More details will be issued in the near future. Compensation Next, Ellis reviewed information related to compensation, which was discussed in last year’s Medical Center town hall meetings. In recent months the administrative team asked the William Mercer Compensation management firm to review the Medical Center’s pay plan and a preliminary report was given in mid-December. Ellis explained that William Mercer is one the nation’s leading compensation management firms and has a experience with the health care industry, including academic medical centers. The Medical Center has relied upon William Mercer through the years as a source of published salary data.   William Mercer was provided a great deal of information from our payroll and HR system, including pay rates and pay practices. They found that 34 benchmark jobs involving around 3,000 employees were paid at 104 percent of the market median. Ellis indicated this is merely a global snapshot that indicates, in general, MUSC pays at market rate and the work with William Mercer is a work in progress. The Medical Center will continue to address specific areas of need.   William Mercer noted that during fiscal year 2005/06 the Medical Center payroll increases exceeded that of most hospitals. Of particular interest, William Mercer reported that the Medical Center relies on two mechanisms for pay adjustments including merit (i.e. performance pay) and equity (i.e. market and internal equity). Mercer reported that the Medical Center gave a large number of equity increases during fiscal year 2005/06 and recommended, as a best practice, that the Medical Center pool merit and equity dollars to enable a more meaningful pay for performance plan.   Ellis reviewed the Medical Center’s pay philosophy and stated the administrative team will continue its work with William Mercer to develop a performance-based compensation plan aligned with best practices to support the organizational goals. MUSC Excellence standards Finally, Ellis discussed the behavioral standards which are being rolled out throughout the Medical Center. MUSC Excellence Standards Team developed the standards. Standards which will serve to clearly articulate behavioral expectations needed to achieve the hospital's goals. All employees are being asked to commit to the standards by Feb. 28.   Applicants will need to commit to the standards before being eligible to file an application. Standards will be included in new hire orientation and in future training. Leaders’ evaluations will include a section on standards and a CATTS module will be set up for an annual standards update. Parking, smoke-free policy Another employee challenge relates to parking. Although a new 1,500-space parking garage next to the new hospital facility will provide some relief, parking will remain a challenge. The MUSC leadership team continues to search for any opportunities to relieve frustration. Last year MUSC contracted with CARTA to provide help with the campus shuttle system. MUSC partnered with CARTA to provide employees a discounted fee of 75 cents each way for using the express service, with free service for the first several weeks. For information, visit http://www.whydrive.net.   On Jan. 1, the campus adopted a campuswide smoke-free policy. Smoking is prohibited in the hospital and the campus complex except in designated shelters/areas. This has made for a big improvement by getting the smoke and cigarette butts away from the entrance of the hospital. Hospital leadership is asking everyone’s cooperation by enforcing the policy by informing employees and visitors of the smoking areas. To access the policy, visit http://www.musc.edu/medcenter/policy/Med/A36.pdf.     Friday, Feb. 2, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.