October 22, 1998

In recent communications meetings, I have updated the management team on the progress of our strategic plan. At its meeting earlier this month, our Board of Trustees approved in principle the updated strategic plan which, among other things, includes restructuring options. Later in this newsletter, the restructuring options are outlined in greater detail.

As frequently discussed, Medicare and Medicaid funding cuts will increasingly affect our budget and our competitive health care market will require us to continue to focus upon cost control. Our objective is to continue to provide the highest quality care while reducing costs. The restructuring options being considered by our Board, as discussed below, are aimed at giving us more opportunities to control costs.

A recent local newspaper article mentioned that our Board is considering these restructuring options while at the same time MUSC is appealing a Circuit Court decision which found the legislation that authorized the affiliation proposal unconstitutional. You may recall the Circuit Court’s findings regarding certain aspects of the case were encouraging to the MUSC leadership and provided guidance. Our Board determined that by appealing the case to the State Supreme Court, MUSC and state government would benefit by achieving final resolution on various issues which will guide our strategic initiatives.

W. Stuart Smith, Interim Vice President for Clinical Operations Interim CEO, MUSC Medical Center

Blood Borne Pathogen Exposure Management

• Laurie Zone-Smith, manager, Special Projects in Clinical Services, presented a new blood borne pathogen (BBP) exposure management procedure. Effective Nov. 1, medical evaluation for employees exposed to BBP will no longer be evaluated in the Emergency Room. Anyone who has a BBP exposure after hours (5 p.m. - 7 a.m. Monday through Friday), weekends and holidays should immediately page the hospital services coordinator (HSC) on-call to begin the BBP exposure management protocol.
• The HSC will now coordinate the patient care for all exposures to blood and body fluids after hours. The HSC will come to your location with the blood borne pathogen packet, assure completion of an ACORD form and begin the exposure management protocol. The HSC will assure all lab work is completed and follow-up appointments are made with WorkMed Carolina the next business day. The WorkMed Carolina physician on-call will evaluate the patient’s need for chemoprophylaxis or other medication specific to the BBP exposure. The Center for Disease Control (CDC) recommends drug therapy treatment to begin within two hours of an exposure to HIV. Employees with all other injuries (slips, falls, etc.) should report to the Emergency Department for evaluation by a physician.
• Zone-Smith thanked the members of the BBP task force: Leader-Mary Allen, Julie Adam, Jodell Johnson, Deb Hutchins, Judy Budinger, Rick Welch, Joe Avant, Claudette Banks, Barry Weissglass, M.D., and Julie Clark. The goal was to decrease the time from a blood borne pathogen exposure to appropriate medical treatment.

Where We’re Headed - Alternatives for an Organizational Structure

• W. Stuart Smith, interim vice president for Clinical Operations and CEO, MUSC Medical Center, reviewed the Clinical Enterprise Strategic Plan goal concerning ownership and legal structure.

• At the recent Board of Trustees meeting, the KPMG Peat Marwick study, commissioned by the Performance Audit Steering Committee of the State Budget and Control Board, outlined four options to be considered as alternative organizational structures:

1. Maintain Status Quo—this option was not recommended since opportunities for cost control and flexibility would be limited.

2. Regulatory Relief—this would require specific laws to be changed for MUSC in regard to certain human resources, procurement, and construction regulations. The details involved for future administration of any modified guidelines could continue to be problematic and also this could raise concerns by other agencies.

3. Public Benefit Corporation—this could enable the Medical Center to remain a state entity but give some flexibility and relief from a cost stand point. It is uncertain at this point as to how this might affect our ability to possibly enter into joint ventures.

4. Become Non-Profit—this would be advantageous in that the Medical Center would no longer be constrained by some of the regulations that limit our flexibility and cost savings opportunities and could enable joint ventures. The downside might be the perception of some that a state asset would be “given up.”