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Currents To Medical Center Employees: We are pleased that recent action by the State Senate restored cuts previously made in the House of Representatives’ budget for the upcoming fiscal year. While the proposed tobacco tax was not passed, $83 million was identified to support the Medicaid program for Fiscal Year 2002/03 at the same level as this year. It is likely the tobacco tax debate will surface again in next year’s legislative session as a means of providing a steady source of funding.  The budget now will go before a House-Senate panel to resolve differences prior to going to the General Assembly to sign off on the compromise(s).  We will not know the final outcome of the budget until the Governor’s approval, which is expected in late May or early June. The state’s Medicaid dollars are matched by the federal government on nearly a three-to-one basis. Had the Senate not identified funds in its budget for the Medicaid match funds, MUSC would be facing a budget reduction of nearly $22 million in the new fiscal year.  Hospitals throughout the state currently pay a hospital tax that is used for additional support of the Medicaid program. This tax was increased in the Senate budget.  MUSC’s current hospital tax is approximately $4 million and, with the additional tax, it will increase by nearly $1 million. While our hospital tax will increase, we are greatly encouraged by the Senate’s restoration of Medicaid match funds.  On another matter, at the recent MUSC Board of Trustees meeting, approval was given for construction work to consolidate all outpatient Cardiology Services on the sixth floor or Rutledge Tower and for various clinical equipment purchases. Also, approval was given for purchase of an Interactive Education and Tracking system as mentioned in recent issues of Currents. Thank you very much. W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center     Meducare exhibits excellent 15-year safety record During the 15 years Meducare has served as South Carolina’s only full-service emergency/medical transportation system, it has enjoyed a stellar safety record, reported officials who described the service at the April 23 communications meeting. During those years, Meducare’s helicopter service has transported more than 9,000 patients and logged more than 10,000 hours flying time. “We’ve never had an incident in which anyone was hurt,” said David Andrews, base manager of helicopters. Meducare is committed to providing high quality professional medical transport services in a timely manner, according to David Pilkenton, Meducare supervisor, who provided an overview of the service and introduced the Meducare staff to the Management Team. Meducare offers helicopter, fixed wing, ambulance transportation and wheel chair services. Vital statistics recorded between July 1, 1987 and March 31, 2002, include: Helicopter Flights—9,051; Fixed Wing Flights—1,068; Critical Care Ground—  7,281;Ground Transports—41,537; Vendored Stretchers—17,103; Vendored Wheelchair—12,579; and Dispatched Transports—89,914. Meducare offers patient transportation services based upon the needs of the patient, including wheel chair services, basic life support, advanced life support, critical care life support for adult, pediatric and neonatal patients. The patient population served include those with cardiovascular conditions, such as acute myocardial infarction, emergent interventional cardiology, cardiogenic shock and heart transplant; head injuries; neurological disorders; acute CVA; high-risk pregnancies; trauma; transplant; metabolic disorders; and burns. Average experience for those providing neonatal/pediatric care is 10 years. Services include advanced procedures such as rapid sequence induction for intubation, central line placement, chest tube insertion, intraosseous line placement, prostaglandin therapy. Meducare Air is a rapid response air medical helicopter, providing a full range of emergency life saving services for critically ill and injured patients who require rapid transportation or advanced levels of care while en route to a specialized care center. The Flight Team is comprised of an EMS pilot, flight paramedic and a flight nurse equipped to handle a range of critical care services, including: Advanced Airway Interventions—RSI, surgical cricothyrotomy, LMA; Ventilator Management; ETCO2 Monitoring; Cardiac Monitoring; Defibrillation/ Cardioversion; Transvenous and External Pacing; Intra-aortic Balloon Pump; Invasive Line Monitoring (Swan Ganz / A-line); ICP Monitoring; Multi-channel Infusion Pumps; Needle Thoracostomy; Extensive Pharmacy with Packed Red Blood Cells; Intraosseous Infusion for pediatrics and adults; and Fluid Warmer. Pilkenton provided the guidelines to determine when to call for a helicopter:  When time matters for the patient When out-of-hospital time needs to be minimized When the patient requires an advanced level of care during transport When it is anticipated that the patient may need advanced airway or pharmacologic interventions enroute When ground transport times exceed 30 minutes and the patient requires advanced life support monitoring When it is anticipated the patient may require packed red blood cells enroute The administrative number for Meducare is 792-9544. The emergency statewide number is (800) 423-1330. To contact Meducare locally, call 792-3311 or, for scheduled transports, call 792-7997. Parking rates to increase, garage to be cleaned  Parking rates soon will increase— the third annual rate hike in four years of planned increases approved by the MUSC Board of Trustees, according to Melinda Anderson, director of the office of parking management. On-campus parking, currently $45 per month, will increase to $50 (although the board authorized an increase of up to $55). Those who park off-campus will see an increase from $20 to $25—$5 less than authorized by the board. The VP parking lot rate increased to $85/month. Students will pay $70 per semester and visitors’ rate will remain at 75 cents each half-hour. All-day rates will increase from $2 to $3. Anderson said there will be no change in the status of free parking at the Hagood lot. Anderson also said Parking Garage #1 will be closed to cars May 3 - 6 for a wash-down cleaning of the facility. The lot will close at 2 p.m. on Friday, May 3. All vehicles must be removed from the garage by 6 p.m. on Friday. Towing of vehicles left in the garage after 6 p.m. may be necessary in order to avoid possible damage to vehicles.The garage will reopen on May 6. MUHA, Hollings Cancer Center nurses meet with federal officials Four oncology nurses from MUHA and the Hollings Cancer Center (HCC) attended the Oncology Nursing Society Congress in Washington, D.C. and met with U.S. Senator Hollings’ staff, U.S. Rep. Clyburn’s staff and Rep. Henry Brown and his staff. Participants included Mary Wilbur, R.N.,  oncology; Hazel Huff, R.N., oncology; Peggy Anthony, R.N., clinical coordinator for Hollings; and Colleen Corish, R.N., clinical director of oncology and medical surgical services for HCC. More than 6,000 nurses attended the five-day congress. On April 17, some 500 registered nurses from 48 states visited Capitol Hill to meet with senators and representatives on the following topics: The Nurse Reinvestment Act, which includes: legislation that will assist in expanded education and training for current nurses; a National Nurse Service Corps; incentives for students to seek masters or doctoral degrees at schools of nursing; new strategies to retain current nurses in the profession; and grants for career ladder programs and nursing training in long-term elder care. Appropriate evaluation and revision of pricing for chemotherapy agents and appropriate reimbursement for the services provided to ensure quality cancer care [e.g. - care that is delivered by specially trained nurses].  “Excellence in quality cancer care is our goal as individual oncology nurses, as well as in the settings in which we work,” said Corish, who presented the information to the Management Team. “Visiting with our state representatives and senators is one way to ensure that our opinions are heard.” Mock survey results show ‘very little wrong’ in some areas, improvements needed in other areas The results of the mock survey held at the end of February showed that the Medical Center has improved markedly in terms of readiness for Joint Commission review. “You all need to give yourselves a big hand,” said Lois Kerr, a consultant with Kerr Associates, a private firm hired to help with the process. “We have a committed leadership to this process,” Kerr said, indicating that particular areas of strength and improvement include handling of documentation overall and adherence to the restraint policy. The Joint Commission Steering Committee meets monthly and is bolstered by organizationwide teams and committees assigned to assess, monitor and improve functioning at all levels of the Medical Center, including pain management, restraints, documentation, acuity, human resource competency, policy, falls, patient safety, medical records, infection control, environment of care, medication safety, and tissue management. Kerr said there are opportunities for improvement in the following areas: securing informed consent (physician responsibility); patient privacy (much improved, but still areas of concern); pain assessment, management and education; pre-anesthesia evaluation; population specific assessments and requirements; patient education; use of medications; patient safety; aggregation and analysis of data; uniform processes of care; implementation of EOC plans; and general infection control issues Kerr said the next step will be for the Steering Committee to develop a timeline for process improvement. McNair Group to provide customer service training A contract was awarded to The McNair Group, a local firm that focuses on management and customer service training, to work with MUHA to develop customer service training and management development training.  The McNair Group will be presenting a “kick-off training session” to introduce itself, give an overview of the planning process for the training program and to interact with and receive feedback from the managers and directors, according to Helena Bastian, director of Human Resources for the Medical Center, who made the announcement.  The kick-off session will be held on May 14 from 9 a.m. - noon at the Storm Eye Auditorium. Volunteer award given to IOP coordinator The SC Governor’s Office awarded Aaron Dunn, an administrative coordinator for Utilization Management at the Institute of Psychiatry (IOP), the Individual Direct Service Volunteer Award. As one of the South Carolina Governor’s Volunteer Awards, the Direct Service Volunteer is defined as “an individual who has excelled in providing direct one-on-one service to an individual or group.” Dunn was nominated by Hot Line, a phone service provided by IOP that offers 24-hour-a-day access to adults and teens in crisis who need someone to talk to regarding drugs, alcohol, suicidal thoughts or depression. Gov. Jim Hodges presented the award to Dunn in Columbia on April 23.  “This award is one more recognition of Aaron’s generosity and altruism which pervade all he does,” said Meredith Bates, Dunn’s manager at IOP.  The announcement was made by Peggy Thompson, IOP financial services manager.  Biohazardous waste containers temporarily downsized Pending the award of a state contract for 96-gallon rollable carts used to dispose of biohazardous waste, the Medical Center will use 30-gallon red containers. Occupational safety and health programs director Joe Avant said the smaller containers, which meet department of health standards, will be used until the larger containers are available. He reminded staff that bags used to dispose of hazardous waste and materials still need to be twisted, folded over and taped to meet safety regulations. “It’s a $27,000 fine if we are caught not securing bags properly,” he said. Avant also mentioned that MUSC’s purchase of the Autoclave system, which is designed to sterilize infectious waste, will, after three years, result in an annual savings to the Medical Center of $240,000. Two Autoclave units were purchased in July at a total cost of $750,000. Infrastructure changes that will support the installation of the sterilization system are under way and are expected to be completed at a cost of $400,000. Currently, MUSC pays 28 cents per pound to dispose of waste. The Autoclave system will allow the waste to be processed into the standard sewage system, resulting in the long-term cost savings.