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Currents To Medical Center employees: I am pleased to announce that our Step Up goal for November is 399,750. Our goal represents 25 percent of the estimated opportunities to demonstrate excellence in customer service behaviors. To update our progress toward this goal, posters will be displayed in various Medical Center locations each week. Some have found it difficult to track and report Step Ups. I suggest that everyone use good judgment and creativity to minimize any burden. Stepping Up should be fun, and tracking should be easy. Our intent is to focus on customer service interactions with patients, visitors, physicians, students and co-workers. Our ultimate goal is to enhance patient satisfaction and employee morale. At our most recent communications meeting Helena Bastian, director of human resources, gave an update on progress toward implementation of a new Web-based interactive education and tracking system. This new system will replace the defunct deMedici system. It will offer a convenient method to meet annual training requirements of JCAHO, OSHA, OIG and others. Medical Center subject matter experts are currently customizing the system for a wide range of  courses. The “go live” date is expected to be January 2003. A contest is being held until Nov. 29 to name the new system. Ideas for names should be submitted to Katy Kuder, Human Resources Office, Room 109 CSB (e-mail kuder@musc.edu).  Thank you very much. W. Stuart Smith Vice President for Clinical Operations  and Executive Director, MUSC Medical Center ‘Presenting: ‘The Good, The Bad, and The Ugly,’  starring the 2003 JCAHO Mock Survey Results Lois Kerr, JCAHO consultant, presented a full report on the findings of the recent mock JCAHO survey and deemed the Medical Center “well on the way to winning an Oscar.”  The mock survey was designed to prepare the Medical Center for the JCAHO survey to be conducted one year from now. The mock survey focused on JCAHO priorities such as patient safety, pain management, emergency preparedness, peer review, medication use, medical records, staffing levels and competency. Among ‘the Good’ was a huge accomplishment for the Center of Clinical  Effectiveness and Patient Safety, greeted by applause from the meeting’s attendees.  “The center was viewed as an example of a best practice,” Kerr said. Kerr pointed to other examples of practices and procedures that the medical center executes very well, like dedicated commitment to patient confidentiality, consistent patient assessment across IOP, CMH, and UMA, and improvement in documentation of medical records, which also received thunderous applause.  Kerr cited an example of Stepping Up with a story about a PharmD sitting at a patient’s bedside diligently going over her medication. “It was great to witness the actual process. It’s not about talking about what we’re supposed to do; it’s about someone doing something right,” she said. Among the ‘the Bad but working on being Good’ and ‘the Ugly’ categories, Kerr cited a need to improve pain management documentation, consistency of staffing variance reports, signing of verbal orders, medical record completeness, and the integration of medical records from UMA, IOP, CMH and the Medical Center.  Kerr also expressed the need to improve the organization of utility and housekeeping closets, as well as medication carts. At the conclusion of Kerr’s presentation, Joan Herbert, administrator for the Institute of Psychiatry, asked for a show of hands to indicate who’d been at MUSC for the last two JCAHO surveys.  “The results of the mock survey this time around indicate that we have a number of things to be very positive about that we wouldn’t have found in past mock surveys,” said Herbert. “We have a to-do list, but for those of you that remember the past surveys, you’ll agree that it’s the shortest list we’ve ever had.”    Medical Center strives to create a ‘Culture of Safety’ Rosemary Ellis, director of Quality, announced the goals of the Patient Safety Program at the Nov. 5 communications meeting. The goal for the medical center is to create a culture of safety by learning from medical errors, sentinel events, adverse outcomes, hazardous conditions, patient safety concerns and near-misses by moving from the current reactive problem-solving strategy to a more proactive one. Citing the Failure Mode and Effects Analysis (FMEA) as a tool, Ellis stated that FMEA is the process of identifying and preventing a problem or error before it happens.  “Unless you thoroughly analyze a problem, you run the risk of fixing the wrong thing,” she said. The last part of her presentation reinforced the idea of the non-punitive culture at the medical center. “Often times in clinical situations we run into risk factors that we don’t always anticipate or can’t predict. When a delivery system fails, competent and caring professionals can end up in unforeseeable situations,” Ellis said. “But there’s no place for blame or shame in a culture of safety.” Shift Differential Rates get an overdue boost Susan Carullo, manager of employment and compensation, gave an update on plans to adjust shift differential rates for certain job categories.  “I think you’ll agree that these new rates are competitive,” Carullo said.  The rate increase pertains to four of five shift differential groups in the Medical Center, namely LPNs, TECs (includes physical, occupational, and respiratory therapists and radiology and medical technicians), Allied Health (e.g., EMTs), and an Other group (e.g., administrative support). RNs will not receive an increase in the shift differential rate but continue to be monitored.  The Medical Center’s budgetary constraints were balanced against other needs for determining the implementation dates for adjusting the shift differential rates. The effective date for LPNs, Allied Health, and the Other categories will be July 2003.  Due to the urgency to address the competitive local job market and recruitment and retention issues, the effective date for the TEC group’s shift differential rate adjustment will be January 2003. For more information regarding the rates, contact Carullo at 792-1684.  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 petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.