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Currents To Medical Center Employees: The recent Medical Center Management retreat, informative and very productive, served to engage the management team in new hospital facility planning to build the foundation for an updated two-year Medical Center tactical plan. A speaker from The Healthcare Advisory Board shared highlights of research regarding health care as we look to the future, with particular emphasis on demographics and changes in care driven by technology. Our health care facilities and architectural consultants gave presentations focusing on our market and an array of facility needs that must be addressed for Phase I of the new hospital. One underscored point said we must not make the mistake of evolving into two facilities giving the perception of different levels of care. Small group sessions generated ideas for the new facility and the topics included: ideal patient encounters, information exchange, enhancing space productivity, movement of patients, transport and way finding. All of the ideas generated will be complied and evaluated by our facilities consultants. We also collected ideas for our operational tactical planning and categorized them as follows: strategies to make the Medical Center an employer of choice for health care professionals, tactics to make the Medical Center a provider of choice for patients and their families, methods to improve clinical care and patient and staff safety, and initiatives to decrease cost of service. The ideas generated around these topics will be refined and assigned to tactical planning work groups who will outline specific objectives to accomplish the tactical plan. Finally, a report on the results of the Medical Center organizational assessment conducted in November 2002 indicated that the Medical Center has continued to improve organizationally.  We need to continue to work on areas such as linking recognition to performance, pay, and communication. The results of the survey will be disseminated soon. Thank you. W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center   STAR Productions presents ‘Beaches’ Concurrent with the theme from the movie “Beaches,” a drama about a terminally ill cancer patient, Rosemary Ellis, Quality director, reminded managers of the importance in understanding Do Not Resuscitate (DNR) orders, as these orders often apply to terminally  ill and other types of patient cases. JCAHO standards dictate MUSC staff to perform cardiopulmonary resuscitation (CPR) for any patient who suffers cardiopulmonary arrest, unless the patient has a DNR order entered into the medical record. If a DNR does not exist in a patient’s medical record, then resuscitation efforts must be aggressive. Ellis stressed the importance in remembering that patients with a DNR may still receive therapeutic interventions for acute, life threatening problems that don’t constitute a full cardiopulmonary arrest. DNR orders are not enacted until the following occurs: The physician documents the discussion with the patient, etc. on the preprinted progress note. The DNR preprinted order sheet is completed and entered into the medical record Residents have discussed with and obtained approval for the order from the attending physician. DNR orders must be reviewed whenever the patient’s condition changes, before anesthesia, surgery or other invasive procedures, and at least every seven days. Physicians should document each review in the medical record. Announcements Vince Dibble, Infrastructure Services director for CCIT, provided an update on the revamp of the campus telephone directory. The new database, or “back end,” has been completed and feedback has been received from the pilot study.  The next step is to create more than 600 spreadsheets by March 31 and send them out for updates.  The new “Find a Person” search engine and all updated directory information are scheduled for completion near the end April with the launch of the new system planned for May.    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.