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Currents To Medical Center Employees: At the recent Board of Trustees meeting, approval was given to proceed with   a number of important major purchases. Most significantly, approval was given for a $2.3 million bi-plane angiographic system for neuro interventional procedures and a $1.9 million MRI. The bi-plane angiographic system will enable us to greatly strengthen the neuro interventional area, which has recently attracted a much needed neuro interventionalist. The additional MRI will establish the Medical Center as a leading institution with four cutting edge MRI units.  On another matter, the new web based Computerized Annual Training and various departments are now piloting Tracking System (CATTS). The CATTS will enable employees to conveniently complete and document “annual mandatory” training requirements. It will also enable physicians to easily complete annual OSHA training. Pilot departments have reported that the system is user friendly.  Following some “fine tuning,” the CATTS will be made available to the entire Medical Center in March. Thank you very much. W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center STAR Productions presents ‘Philadelphia’  Terry Wilson, Pastoral Care coordinator, spoke about advance directive policy for the medical center at the Feb. 18 communications meeting and reiterated its importance.  Using a clip from the movie “Philadelphia” starring Tom Hanks, Wilson demonstrated the confusion that may result if a patient has not declared who should handle care if he or she is incapacitated. Advance directives are defined as an oral or written legal statement by an adult possessing mental capacity expressing his or her wishes regarding medical decisions in the event of mental incapacity. Policy C-12 states the purpose of advance directives is to foster a pattern of patient responsibility for their own health and health-related behaviors, to create a culture of sensitive and honest discussion of end-of-life concerns and health care, and to engage the active participation of patients in health care decisions. Wilson said two advance directives are the declaration of desire for a natural death (“living will”) and a Health Care Power of Attorney (HCPA). The declaration is a patient’s way of saying how aggressive medical treatment should be in the event of permanent unconsciousness or terminal illness. The power of attorney designates an individual, other than the patient, to handle medical care in the event of temporary or permanent mental incapacitation, and includes life-sustaining treatment directives.  The four options for life-sustaining treatment include grant of discretion, directive to withhold or withdraw treatment, directive for maximum treatment, and directive in the patient’s own words. If a patient does not have a HCPA and cannot speak for him or herself, the legal next of kin will make the health care decisions. Contact Wilson and the pastoral care staff at 792-9464 to answer any questions concerning advance directives. Policy Updates In other news, Mary C. Allen, Quality Management, told managers about two new proactive policies, the cryogenic gas policy and the nurse call system contingency policy.  Cryogenic gas: Several areas including OR’s, Labs and some clinics in the Medical Center use medical grade liquid gases such as Nitrogen, Oxygen and Helium, therefore the policy illustrates safe use and storage related to cryogenic gas, including first aid procedures in the event of liquid gas spill or exposure. Managers are to insure that personal protective equipment, MSDS, and emergency equipment are readily available. Likewise, all employees who have potential for occupational exposure to cryogenic gas must receive training. For training, contact Al Nesmith’s office at 792-6902 or call David Marek, Medical Gas coordinator, at 792-1478. For cryogenic gas spillage or area hazard assessment, contact OSH (792-3604).  Nurse call system contingency policy: This policy facilitates the quality and safety of care where installed electronic call systems are in use. The contingency operates on a similar principle that the patient has the ability required to operate the built-in call system. In the event of inpatient system outage, the phone system rather than nurse call system becomes the primary method of communication. Staff members are to contact Communications, assess patients affected, provide instruction and place the phone in patient/family reach. Patients do not have to be able to speak, an individual need only to press “0” on the keypad. The call is transferred to the Nursing desk where nursing staff triage calls for assistance. A redundant feature is the use of manual call bells, available from the Equipment Distribution Center (EDC), to be provided within patient reach as additional method to call for assistance. It was emphasized that no call system is a replacement for the monitoring of patients. Area staff will manage patients affected by call bell outages in Ambulatory areas.  JCAHO Staffing Indicators Allen also provided a presentation on the new HR.2 Staffing effectiveness standard. The standard went into effect July 2002 and although titled as Human Resources, it’s applicable throughout medical center clinical inpatient areas. Scoring on the HR.2 standard may also affect scoring in Leadership, Performance Improvement and Information Management.  Staffing Indicators are organization wide, selected by leadership, and include the correlation of patient satisfaction to worked hours and medication errors to turnover rates. Currently, worked hours for MUHA Employees are graphed with the majority of worked hours attributed to regular worked hours. Overtime of MUHA staff is low, however, traveler, agency and per diem time will be added in and will likely account for additional regular and overtime worked hours. MUHA employee turnover rates are considered acceptable based on benchmarking from JCAHO. Special attention to medication safety, error identification and reporting are ongoing.  To facilitate the exchange of staffing effectiveness information, an Intranet based Web site under Quality management network will be available. Directors and managers, using their MNA login and password, will be able to access the overall and unit based staffing indicator information. Managers must insure that all staff members are familiar with this information. Quality management staff will work closely with unit managers to identify and document opportunities for improvement.  Announcements Helena Bastian, Human Resources director, reviewed medical center policy concerning military leave. In addition to the 15 days awarded annually to National Guard or U.S. armed forces reserve members, 30 days of leave is granted without affecting the employees earned leave (PTO) when called to active duty.  Each qualifying employee is limited to 30 days for a national emergency as declared by the President. The employee must present military orders to their respective manager and Human Resources. Employees called for active military duty have full reemployment rights for up to five years. Employees may refer to HR Policy 22 or contact Human Resources (Sheila Griner, 792-0857, Susan Carullo, 792-1684, or Eric Frisch, 792-7908. ). Questions regarding benefits should be directed to Janet Browning at 792-1208.   Michael Irving, Patient Care Systems manager, announced the extension of the Nursing Clinical Documentation naming contest until March 7. Irving distributed flyers and asked managers to post them throughout the medical center. A modest cash prize is available. Entries may be submitted to http://www.musc.edu/medcenter/clindocname.html.  Payroll deduction is now offered in the gift shop for all Hospital Authority employees. Eliminating the need to carry cash or credit cards, the new program allows employees to make charges against their paycheck.   A minimum purchase of $10 is required to qualify for payroll deduction.