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Currents To Medical Center Employees: Fiscal Year 2002-2003 has been exciting and challenging.  As we prepare to close a successful year, now is a good time to reflect upon some of our accomplishments. The Children’s Hospital was cited by Child Magazine as being the best Children’s Hospital in the southeast. Solucient, a health care research firm, recognized MUSC as one of the top 100 cardiovascular hospitals in the nation. For the fifth consecutive year, the MUSC Medical Center received the National Research Corporation’s Consumer Choice Award for the highest quality and image in our market area.  We continued to provide high quality and compassionate care while achieving record-setting admissions and outpatient visits. Admissions increased by a projected 1 percent and outpatient visits increased by a projected 4 percent. We remain cautiously optimistic that we will achieve a positive bottom line for this fiscal year.  Substantial progress was made with capital improvement projects.  Renovation work was completed to accommodate the 3 Telsa MRI in the Clinical Sciences Building. The operating room project including a new PACU and waiting room space was completed. The adult emergency room renovation and the hospital flooring projects were completed.  The Two East inpatient unit was reopened as the Joint Replacement Center and Short Stay Unit. The Heart and Vascular Center on the fifth floor of the Children’s Hospital was completed. A much needed redundant power system for the Main Hospital was completed.  MUSC leaders made good progress on critical tasks needed for the phase one replacement hospital to become a reality including positive outcomes in working with the City of Charleston, VA, HUD, key elected officials and DHEC. The Board of Trustees approved the clinical facilities plan for the phase one replacement hospital.  The patient safety program was fully implemented. The ambulatory pharmacies’ substantial increase in volume favorably contributed to the Medical Center’s financial margin and the pharmaceutical outcomes management program identified significant medication savings. Necessary preparation was made to comply with the new HIPAA privacy law, including training for all employees. A number of systems-related improvements were made such as the web-based payroll/H R reports, implementation of a new online training system to accomplish required annual training, and the new online budget system.  The above lists major accomplishments and certain operational improvements. Numerous other important achievements are not listed. The many accomplishments this year have taken a huge group effort and I would like to thank everyone for a job well done. The future promises to be exciting.  Thank you very much. W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center   STAR Productions presents ‘Awakenings’  Lisa Kindy, Clinical Risk Management director, opened her presentation on informed consent with a scene from the film “Awakenings” starring Robin Williams and Robert DeNiro. In the scene, Williams character goes to a patient’s mother to gain informed consent for new treatment. Kindy picked this scene to highlight what should happen in the clinical setting. Informed consent dovetails into risk management, Kindy explained. The foundations of informed consent come from the following JCAHO standards: hospitals must promote patient and family involvement in all aspects of care and consent, informed consent is a legal doctrine involving the fiduciary duty in the physician patient relationship and the patient’s right to self-determination, and informed consent is used to establish communication and rapport with a patient when managing risk. According to Kindy, the physician is responsible for providing the patient with the information necessary to make an informed consent. At MUSC, an attending physician may delegate the actual function of obtaining the informed consent to a resident who has the proper training and experience. All informed consents require the signatures of the physician, the patient and a witness. JCAHO standards require that informed consents serve to clearly explain procedures and treatments to patients, explain potential benefits and drawbacks, discuss potential problems, explain likelihood of success, discuss possible effects of non-treatment, and significant alternatives to the treatment. Every competent adult patient has right of refusal for a given treatment, and should this occur, it must be documented in the medical record. This standard mandates that a competent patient’s refusal may not be overridden in a life threatening situation (i.e. Jehovah witness’ right to not receive blood transfusions).  Informed consents have some limitations; for example, they must be done in a timely manner, for specific procedures or specific sites, and are subject to some exceptions like implied or emergency consent situations. Staff members are responsible for informing patients of the name of the physician or practitioner who’s primarily responsible for their care, identity and professional status of person responsible for authorizing and performing any treatments or procedures, and if there are any professional or business relationships with other health care institutions, etc. involved in the patient’s care. “This is where we understand how informed consent dovetails into risk management,” Kindy said. “The number one cause of lawsuits in the hospital setting is miscommunication or lack of communication. Through informed consents you can develop a rapport with the patient, describe pain responses, risks, and the length of recuperation for the procedure.” In addition, Kindy maintained informed consent helps patients to avoid unreal expectations and thus frustration, as well as the importance of individualizing the form to each patient and documenting in the medical record. Piggly Wiggly to Partner with MUSC Diane Colgan, Marketing director for Piggly Wiggly, told managers about a new program between the Pig and MUSC. Beginning July 4 and extending through Labor Day, MUSC employees will receive double Greenbax with the help of a special card when grocery shopping.  In return, MUSC will bring two health fairs to Pig employees in North Charleston and Jedburg. The double Greenbax cards are attached to a pamphlet detailing hundreds of local and state vendors, like movie theaters, pizza places, and other retail stores, that either distribute or take Greenbax stamps in place of cash.  Cards will be available for all MUSC and MUHA employees on July 2 in the Volunteer Services office on the first floor of the Children’s Hospital.  For additional  information concerning the program, look for announcements in The Catalyst and Broadcast  emails, or contact Heather Murphy at 792-7669.     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.