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Currents To Medical Center Employees: The phase I voluntary smallpox vaccination program has been implemented. In keeping with a national trend, our phase I did not include a large-scale voluntary vaccination of employees. Instead our program focused on broad-based education and targeted voluntary vaccinations to ensure for an appropriate level of preparedness while minimizing any risks to our patient population.  Our planning process for phase I included designation of a first response team to recognize and treat adverse side effects (vaccinia) to the smallpox vaccination. Also, a critical mass of physicians and staff voluntarily took the vaccination in late March in ensure an appropriate level of preparedness in the event of a smallpox bioterrorism incident.  The Centers for Disease Control (CDC) is leading the national effort for the smallpox program. The State Department of Health and Environmental Control is responsible for the statewide coordination. Currently, DHEC reports waiting for recommendations from CDC before proceeding with the phase II voluntary smallpox vaccination program. Phase II will focus on firemen, police, EMS and other first responder teams. It is expected that phase II voluntary vaccinations will begin in late spring or early summer.  Several months ago the voluntary smallpox vaccination program drew considerable attention from health care providers and the media. In recent weeks the Severe Acute Respiratory Syndrome virus (SARS) has captured our attention. Please refer to the MUSC Medical Center for Clinical Effectiveness and Patient Safety website (www.musc.edu/cce/ORDFRS/) or the Infection Control Department for information concerning SARS.  At a recent meeting, Marilyn Schaffner highlighted the Main and Ambulatory operating rooms. She reviewed the evolution of the Ors, noting the transition from 12 to 21 OR suites in the Main hospital and Ambulatory OR growth from three rooms in the Clinical Science Building to seven OR suites and two procedure rooms in Rutledge Tower. Volume in the Main OR is up 7.9 percent during the last year with Ambulatory OR volume up 6.3 percent.  The top three services for chargeable minutes for the main OR are cardiothoracic, orthopaedic and general surgery and for Ambulatory OR, the top services are opthalmology, otolaryngology and orthopaedic surgery. Services in the Main OR with the fastest rate of volume growth during the past year are as follows: general surgery is up 16.5 percent; neurological surgery is up17.8 percent and orthopaedic Surgery is up 16.8 percent. Services in Ambulatory OR with the fastest rate of volume growth are orthopaedic surgery (up 37.5 percent) and otolaryngology (up 20.5 percent). Between July 2002 and February, 6.8 percent of patients discharged were surgical patients accounting for 54.83 percent of total inpatient charges.  Main OR staffing improved dramatically during the past 2 ½ years. In 2000, there were 23 travelers and 19 orientees, today there are no travelers and  four orientees. Schaffner gave credit to the leadership and teamwork amongst the OR staff and cited an example of this teamwork—the Room Turnover Project— which resulted in decreasing the Main OR room turnover from 43 minutes to 22.37 and from 21 minutes to 14 minutes in Ambulatory OR. She also announced the Main OR received the Best Teams 2003 award from Advance for Nurses, a biweekly professional nursing journal that serves Georgia and the Carolinas. Marilyn concluded her presentation with thanking the Board of Trustees for their support.  Thank you very much. W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center   STAR Productions presents ‘As Good As It Gets' Opening with a scene from the film “As Good As It Gets” which served to demonstrate the “ideal” continuum of care for patients, Lynne Nemeth, Care Management, Research and Evaluation director, informed managers on JCAHO standards and discussed the process for insuring quality patient care. She defined patient care as an “integrated system of services, settings, health care practitioners, and care levels that make up the continuum of care.” The goal of MUSC and JCAHO standards according to Nemeth is to define, shape, and sequence processes and activities to maximize the coordination of care within the continuum of care. In conjunction with the JCAHO theme of determining care based on patients’ needs, Nemeth presented the following MUSC standards: Before admission—Identify and use information pertaining to patients’ needs and communicate with other care settings and organizations if necessary. Admission—Services must be consistent with hospital mission, populations served and settings. Responsible for making arrangements with other necessary organizations and settings to facilitate patient education, refer and transfer patients to meet needs based on intensity, risk, and staffing levels. In hospital— Services must flow continuously from assessment to treatment to reassessment and practitioners must coordinate services. Before discharge—Needs and status for continuous care assessed and administer patient education. Discharge—If needed, must be directly referred to practitioner who meets patients’ needs. Use and value of continuum of care must meet assessed needs. Hospital responsible for providing information and data to help other practitioners meet patients’ needs.  For more information on JCAHO standards concerning the continuum of care, go to http://www.musc.edu/medcenter/JCAHO/index.html. Elevator work to continue Fred Miles, Plant and Hospital Maintenance manager, updated managers concerning the current elevator upgrades. While the elevators will not change much in outer appearance, Miles assured those present that the Medical Center is committed to repairing and restoring 16 elevators, including eight in the main hospital and eight in the children’s hospital. Maintenance began April 14, with two passenger/visitor elevators and one service elevator out of service in the Children’s Hospital for upgrading for up to two months. Any problems with the remaining five elevators in the children’s hospital be addressed immediately and additional phones have been installed in the Children’s Hospital lobby and the 7th and 8th floor main corridors. Managers were asked to remind vendors and staff that supplies, equipment, carts, etc. must be transported on a service elevator, as the passenger/visitor elevators must remain available for passenger travel only. To find out which elevators are down or to report additional problems, call 792-4119 for questions        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.