July 9, 1998

The steering committee for our strategic planning process met for the last time on July 7 to review and approve the draft of the revised strategic plan for the Medical Center. This draft will go first to MUSC president James B. Edwards, DMD, then to the MUSC Board of Trustees at its August meeting. At this time, plans are for the board to hold a retreat in October to consider final action. More information will be disseminated as we move forward.

On another note, earlier this year MUSC, was given the distinction of being designated as one of the top 100 hospitals in the country and was named among the top 100 research universities in national rankings. As a memento and token of appreciation for a job well done, the Medical Center has obtained small insulated coolers, ideal for carrying lunch and beverages, for all MUSC employees. Members of the former “Me Issues Committee” recommended this as a useful token.

At the July 7 communications meeting, we heard from several of the groups working on the opening of MUSC Rutledge Tower. The progress being made on this building has been a marvel to watch over the last year. Judging by the tremendous effort so many people have put into this project, I am confident that the tower and its grand opening will be a success.

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

Announcement

Equal Employment Opportunity and Affirmative Action Training Available on Videotape

• The MUSC Office of Diversity for a number of months has conducted training sessions on equal employment opportunity, affirmative action and related laws and policies. In December 1997, Willi Glee, equal employment coordinator, conducted a training session during the communications meeting for all Medical Center managers. A summary of Glee’s presentation was issued in Currents at that time.
• More recently, Glee’s training session has been videotaped. Copies of this videotape are being given to Medical Center directors to enable all employees within the Medical Center to conveniently take part in this training. Anyone who would like more information or who wishes to pick up a copy of the videotape should call Jane Smith at 792-4120.

MUSC Rutledge Tower Opening Draws Near

• At the July 7 communications meeting, the management team heard updates on various aspects of the MUSC Rutledge Tower opening, which is among the biggest projects ever undertaken at MUSC. Hal Currey, associate dean for operations, Dean’s Office, College of Medicine, said while there still is a long list of things to be completed at the tower, everything is progressing well. A temporary certificate of occupancy was awarded on July 1, and the building has passed all city inspections. A Department of Health and Environmental Control inspection was scheduled for July 8. The inspection will be completed on July 15.
• Kristen Karig, MUSC Public Relations, and Lisa Giles, community outreach coordinator from Marketing Services, outlined the activities planned for the grand opening.
• Wednesday, July 22: A grand opening ceremony begins at 10 a.m., followed by refreshments and a self-guided tour of the first and second floors of the building.
• Thursday, July 23: MUSC and Carolina Family Care physicians, plus referring physicians from the community and around the state have been invited to a drop-in open house from 5:30 - 7:30 p.m. The self-guided tour also will be available.
• Friday, July 24: MUSC employees and students are invited to an open house and to take the self-guided tour from 1 - 5 p.m.
• Saturday, July 25: An open house for the public is planned from 10 a.m. - 2 p.m. with approximately 55 different activities and displays, including:
• Project Kid Care photo I.D. kits from sponsor Sunny 96.9.
• Breast cancer and breast self-exam information from sponsor Channel 5.
• A teddy bear clinic where children can learn what to expect at a visit to the doctor. q Bone density scans and milkshake samples from the Better Bones Tour, sponsored by the National Dairy Council and the National Osteoporosis Council (MUSC Radiology will assist with the scans.) Participants also can enter a national contest to be in a “milk mustache” ad.
• Free health checks—pulmonary function, blood pressure, hearing, blood glucose, skin cancer and cholesterol. q Displays and activities like “meet the physician” on all ten patient care floors of the tower.

Mackey Grimball, manager of planning and facilities management for Ambulatory Care Services, and Karen Weaver, director of Surgery and Women’s & Infants’ Services, discussed plans for moving the clinics. The approach being used is described as “aggressive,” with large moves taking place in two phases.

• The firm of Allied Healthcare Systems was chosen to help with the move. AHS, which worked with Bon Secours-St. Francis Xavier Hospital during its move, is an experienced firm with a strong track record. Grimball shared recommendations from AHS on how to have a successful move:
• Clean house—get rid of obsolete items—before the move. When in doubt about an item, leave it behind. If it’s needed, it can be retrieved later.
• Properly label everything by department.
• Be ready on time for the movers.
• Make sure movers have complete access to elevators, through corridors and to loading docks.
• Prepare MUSC Rutledge Tower. Punch lists should be complete and all new furniture, equipment and phones should be in place before moving day.

The moving schedule, as outlined by Weaver and Grimball: q July 26: AHS will be in town for set-up and to iron out final details.

• July 27 and 28: A pre-move is planned to move up to 20 percent of items not needed for daily operations (such as books) into the tower ahead of the main move.
• July 29 - Aug. 1: Phase I. All ambulatory care clinics, preoperative services, orthopaedics (from 30 Bee St.), and support services (pharmacy, radiology, laboratory) will close July 30 and 31 to move. They will reopen Aug. 3 in the tower. (Mammography, originally scheduled to move at this time, will instead move in September.)
• Aug. 5 - 7: Phase II. Physical and Occupational Therapy from 30 Bee St. and MUSC Digestive Disease Center will close Aug. 6 - 7 to move and will reopen Aug. 10. Ambulatory surgery will be the last to move, closing Aug. 5 - 7 and reopening Aug. 10.

• Mark Ruppel, transplant liaison with MUSC Transplant Center, gave the management team an overview of proposed new regulations that threaten the existence of MUSC’s transplant program. Under the current system, organs procured in a state are offered first to the sickest patients in that state, then to those in that state’s region, then to those in the nation. New regulations proposed by the U.S. Department of Health and Human Services would base decisions solely on medical necessity. This system would favor larger transplant centers and put medium-sized and smaller centers at a disadvantage.
• To illustrate one of the effects of the regulations, Ruppel showed how they will add an estimated 53 days to the wait for a liver in MUSC’s region. At the same time, the wait in a region that includes one of the nations larger transplant centers will be shortened by only four days.
• Ruppel said while the larger centers have so far won the “media war” by using the “sickest patient first” angle, the position of centers such as MUSC is finally being heard in Washington, D.C. and in the news. MUSC is working with other medical centers nationwide and with South Carolina legislators to get the whole story out about how the regulations will affect not only transplant centers, but more importantly, transplant patients. The new rules are scheduled to go into effect for liver transplants on Oct. 1. A “comment stage” ends Aug. 31. During this time, opposing and supporting views can be forwarded to: Jon. L. Nelson, associate director, Office of Special Programs, Health Resources and Services Administration, room 123, Park Building, 12420 Parklawn Drive, Rockville, Maryland, 20857. Ruppel urged everyone to consider the issue and send an opinion to Nelson.
• Ruppel distributed the following summary, “Potential Problems With Proposed Health and Human Services Transplant Regulations.”
• The proposed new Health and Human Services organ-transplant regulations represent a radical change that would federalize a system that should be governed by private-sector, medical community cooperation. It would save fewer lives, contribute to higher medical costs for patients and hospitals, exact an especially heavy toll on poor and rural Americans, raise serious medical ethical questions and shut down operations in excellent hospitals throughout the country.
• Federal mandate vs. medical consensus. The unilateral imposition of this federal mandate would override a cooperative system developed by medical experts and the broader transplant community. Federal law requires that transplant policy be made in the private sector, with guidance from the government. This proposal ignores the principle articulated by President Clinton that, “Medical decisions should be made by medical doctors.”
• Fewer lives saved. Under the new federalized regime, fewer patients will get transplants and fewer lives will be saved. Transplanting more livers only into the very sickest patients will mean more repeat transplants (and fewer organs for patients). Organ wastage will rise, because, contrary to HHS’s contention, all livers cannot be shipped throughout the country without harm to the organ and the patient. And, most damaging, liver donations would fall as local transplant centers close, leaving fewer organs available for transplant.
• Decrease in organ donations. The highest priority and most important issue for the federal government and the medical community should be to increase the number of organ donations. The major problem today is there simply aren’t enough available organs for patients who need them. If the number of organ donations rose sufficiently, most concerns and disagreements about allocation systems would disappear. Yet this proposed regulation would actually decrease donations. Evidence shows that donations increase when centers open and decrease when they close. By moving from 120 transplant centers to about six, donations are sure to fall.
• Higher financial cost. Requiring that patients become gravely ill in intensive care treatment to qualify for a transplant will result in higher health care costs. There will also be increased costs associated with transportation and lodging for patients and families, as they will be forced to travel to distant centers for treatment, and for the transportation of organs.
• Hardship for working families. Increased travel will split up families, destroying psychosocial support networks so critical to recovery. Poorer families will not be able to afford to travel great distances, and patients’ loved ones will not be able to be near them during transplant procedures that can last many weeks or months. Families with children cannot leave them home unattended. Patients from rural areas in particular will have to travel greater distances as local centers close.
• Disruption of ethical principles. The current cooperative policy strikes a balance between treating the sickest patients fairly and saving the greatest number of people. The medical community believes there is an ethical obligation to balance fairness, justice and medical utility in setting allocation policies. The HHS proposal would skew the policy away from helping the most people to the exclusive goal of helping the sickest.
• Fewer transplant centers. A great medical success story is the growth in liver transplant centers form just two in 1983 to 85 in 1990 to 120 today. The new HHS system would divert a declining supply of donated livers to an estimated six large treatment centers with the longest waiting lists of very sick patients. This would force most transplant centers to close their doors, contributing to a decline in donations and the loss of talented doctors.