Jan. 22, 1998
A recent University HealthSystem Consortium (UHC) meeting for board
members, CEO’s and other clinical enterprise leaders focused upon the topic
of “Competing in a Maturing Marketplace: A Midcourse Review.” Two MUSC
Board of Trustees members, Dr. Stanley Baker and Mr. Robert Lake, and I
attended the meeting. I would like to share with you the highlights of
the meeting and more specifically how the Medical Center has fared with
its strategic initiatives compared to other peer institutions. During the
meeting, we revisited strategic initiatives formulated by leading academic
health centers three years ago. Key strategic initiatives embraced by many
UHC members at that time included: primary care development, infrastructure
development, network development, cost reduction and development of insurance
products. The MUSC strategic plan, which was kicked off in 1993, was closely
aligned with those adopted by other UHC members, except for the development
of insurance products.
The presentations at the meeting underscored that development of a primary
care network and referral base continues to be very important and we have
high marks in this area. The consensus among the UHC members also was that
much emphasis needs to continue to be placed upon development of infrastructure
. . . which to us means improvement in information systems, operating systems
(such as the “Oversite” outpatient scheduling system) and facilities. While
our progress with infrastructure development has been difficult and time
consuming, we continue to make headway.
Regarding network development, we heard updates from a number of academic
health centers that have merged with community hospitals. This suggested
that MUSC’s affiliation proposal, while delayed, was conceptually sound.
It was also emphasized that much attention needs to be devoted to cost
reduction. We have made progress with reducing costs, but clearly we must
continue our efforts to be more efficient and reduce costs.
MUSC did not pursue development of insurance products as did some of
our peers. It appears that we were fortunate not to have included insurance
among our strategic initiatives, since many academic health centers have
experienced poor results in this area. I came away from the meeting feeling
very good about our progress with most of our strategic initiatives. We
started with a good plan, and we followed it. As we near the end of our
planning cycle, our board and leadership team will revisit our strategic
initiatives in view of the dynamics of our health care environment.
I am convinced that with the dedication of our employees and the strong
support of our leadership we will continue our success.
W. Stuart Smith, Interim Vice President for
Clinical Operations CEO, MUSC Medical Center
- John Franklin, director of Support Services, announced that the results
of a Request for Proposal for a new environmental services company are
in and that Crothall Healthcare, Inc., received the contract, effective
Feb. 1. At the Jan. 20 communications meeting, Franklin introduced Harry
Webster, a district manager from Crothall Healthcare, Inc., who will be
in charge of start-up for the new contract. Webster has 17 years of experience
in the field of health care environmental services. Franklin and members
of the new Environmental Services management team will be visiting departments
in the Medical Center to discuss individual needs for each area. (MUSC
Environmental Services staff will remain.) He also thanked the core group
responsible for facilitating the RFP process: Gene Boyd, John Cooper, Carol
Dobos, Sue Pletcher, Peggy Simmons, Marc Summerfield and Karen Weaver.
He said this group also is helping with the RFP for linen and food services.
- Carol McDougall, coordinator of Clinical Services Education, distributed
flyers on two upcoming seminars.
- April 8: Legal Issues in Health Care, for health care staff members.
- April 9: Supervisory Issues in Nursing and Health Care, for health
The seminars, presented by the Medical Center’s Clinical and Patient
Education area, and cosponsored by the Low Country Area Health Education
Center, will be held at the Francis Marion Hotel on King Street. Both feature
the speaker Patricia C. McMullen, M.S., J.D., N.P., RNC. McDougall said
that McMullen is a dynamic and energetic speaker and urged all who can
attend to do so. The cost for MUSC employees and students is $25 per person,
per seminar. Flyers with more information can be obtained by calling 792-2409.
- Tom Keating, administrator for Finance and Support Services, said that
the Department of Health and Environmental Control conducted a licensing
inspection at the Medical Center last week. The Medical Center has been
relicensed, but will be working on an action plan to resolve one violation
noted by DHEC regarding improper storage. Keating reminded all managers
to stress to staff members the importance of following the procedures and
keeping the good habits we established during the Joint Commission on Accreditation
of Healthcare Organizations’ survey in August.
- Laurie Zone-Smith, manager of Employee Health Services, distributed
a handout of Workers’ Compensation information. The handout includes contact
people and phone numbers for WorkMed Carolina (the Medical Center’s employee
health services provider) clinics and staff members as well as MUSC employees
who are responsible for medical claims management of work-related injuries
or concerns. Copies of the phone list can be obtained from your manager
or by calling 792-7769.
Reporting Sentinel Events
- At the Jan. 20 communications meeting, Pam Cipriano, Ph.D., R.N., administrator
for Clinical Services, discussed sentinel events—the unexpected or unanticipated
loss of life, limb or function—and the Medical Center procedure for reporting
and investigating such events. Cipriano said regulations regarding reporting
sentinel events are changing, and criteria defining such events is expanding.
Categories of sentinel events now include (in addition to the unexpected
loss of life, limb or function) the abduction of an infant, the discharge
of an infant to the wrong family, rape by another patient or a staff member,
hemolytic transfusion reaction, and surgery on the wrong patient or body
part. “Near miss” events also are included in the regulations.
- Cipriano discussed the process that must occur after an event that
may be considered sentinel. The event is reported to Risk Management, which
uses a rating system to determine how an event should be handled and enters
the information into a database. If the event meets the criteria for a
sentinel event, certain reporting and review procedures must be followed.
- MUSC’s procedures include reporting sentinel events to the medical
director, members of management staff and the Quality Council. Detailed
information on sentinel events is recorded so that a thorough job can be
done in determining the root causes of events and so that an effective
action plan can be developed to respond to each event. (For example, if
the council finds that an event could have been prevented if different
procedures had been followed, it can assign a performance improvement project
to the departments involved or institute hospital-wide staff member education.)
- A flow chart outlining the procedure for reporting and investigating
sentinel events is being added to the current policy and will be included
in the policy manual.
Work Station Support Update
- Dave Northrup, director of Healthcare Systems, and Bill Rust, manager
of Healthcare Network Services, in the Center for Computing and Information
Technology, gave the management team an update on efforts to improve service
in the area of work station support.
- Northrup said he realizes there has been a good amount of frustration
in the last year about the lack of enough work station support, periods
of e-mail downtime and server difficulties. He said CCIT is doing its best
to improve service levels. He also reminded managers of who the contact
people are in CCIT for each area of the Medical Center.
- Rust explained how changes in the structure of CCIT have affected Medical
Center work station support. In June 1996, the decision was made to combine
work station support for the university, administration and health care
functions into one area. This benefited some areas, as it gave them access
to more staff members and resources. However, it resulted in a reduction
in service to other areas.
- During this time of change, CCIT continued to operate with the same
number of employees and the same resources, but with a dramatic increase
in workload. For example, an average of 100 new PCs have been added each
month for about three years. Rust said service levels reached a critical
low, and the department struggled with finding a solution.
- Because of several funding issues, a decision was made to once again
break up the PC support group. As of December 1997, the three areas (university,
administration and health care) are again served by different work station
- Rust said Healthcare Network Services today has a better staffing ratio,
a better focus and renewed energy and commitment to improving service in
the Medical Center. The area includes system engineers, field engineers,
client support specialists and a trainer. It maintains 55 file servers
throughout the Medical Center, and receives more than 200 calls for service
each week. Rust said the area’s goals are to reduce the backlog of calls
for service to 150 (from 210 currently) and establish service level goals
by March 1, and to fill its three vacancies by March 15.
- Rust also discussed plans to bring ClinLAN into “the next generation.”
He said ClinLAN95 is being developed, with a roll out planned to begin
in the second quarter of this year beginning with electronic medical record
system users (such as those who use Oacis). Extensive training will be
key in the roll out.
- Northrup added that although the original plan was to forego Windows/95
in favor of what will follow it, it now appears that Microsoft’s development
of its next system, Windows/NT will not meet the Medical Center’s timetable.
He said that some applications—most notably the electronic medical record—need