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Currents To Medical Center Employees: The JCAHO’s Standards and Procedures Committee recently approved a new   “leadership” standard regarding patient flow. The new standard becomes effective in January and will appear in the online JCAHO Accreditation Manual in the fall.  It is noteworthy that as I prepare this message our main hospital has no available beds and five patients are in-house awaiting beds. The purpose of the new standard is to focus on patient flow from assessment for possible admission to discharge, and to identify ways that efficient patient flow impacts safety and quality.  Recently Lois Kerr, accreditation manager, advised the administrative team that patient flow will become an overarching issue in the same realm as patient safety. According to a JCAHO publication, this new standard was developed in response to growing concerns in the health care field about increasing congestion in recent years. Patient flow problems can lead to treatment delays or sentinel events. The new standard, among other things, serves to underscore that the clinical and administrative leadership teams must mobilize departments throughout the organization to better govern patient flow and prevent overcrowding in order to provide the safest and highest quality care to patients. The work of our Bed Capacity Task Force, which has been led by Dr. John Heffner, medical director, since November 2003 is closely aligned with the new patient flow standard.  Dr. Heffner has recently pointed out that currently many people are working hard, but the “parts of the engine need oiling.”  Nearly all clinical, educational and support services have an important role to play in addressing this “front burner” issue. Clearly we have opportunities for improvement with patient flow and everyone’s cooperation and best efforts will be needed.  On another matter as discussed below in this newsletter, we will be participating in a mandated Tricounty disaster preparedness drill. The drill is expected to take place on the late night on Aug. 20 and 21. Please be prepared.  Thank you very much. W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center Cards help prepare for areawide disaster drill set for Aug. 20 George Bryan, M.D., the Medical Center’s designated clinical link to disaster preparedness spoke to those gathered at the weekly hospital communications meeting Tuesday about the hospital emergency incident command system, planning for operations level disaster planning and preparation for an areawide disaster drill on Aug. 20. The hospital emergency incident command system (HEICS) is a system being implemented around the country based on the premise that day-to-day management is not sufficient during a disaster or a crisis. “A lot of the disaster plans weren’t realistic, weren’t universal and varied among hospitals,” Bryan said.  HEICS addresses management and leadership structure during a disaster. Being a management system, it does not address operations level clinical functions, Bryan said, and that is something that needs to be worked on. “We started the Clinical Disaster Preparedness Committee that includes nurses, HSCs, ER nurses, techs and several doctors. We have started to address issues more to do with the ER, and we are now ready to expand outside the ER and into the rest of the hospital in the clinical arena.”  He said that the committee wants to increase the involvement in drills, which has been done with the ER in the last year or two. To help with the problem of nurses having so much to do, with new nurses coming in and with traveling nurses, the committee has produced disaster preparedness role cards as a quick reference tool in a crisis. “The cards prioritize tasks,” Bryan said. “They make it less necessary to take time to think about what to do.” One of the considerations key to the system is what to do with the patients already in the hospital when casualties are arriving. “It’s going to be important for us to get ready,” Bryan said, outlining procedures that would place patients with minor problems in the waiting room, and move others into the hospital even if their rooms aren’t completely ready for them. Bryan said that there are 20 cards covering as many different roles in a disaster, including roles for doctors. The cards are laminated and would be passed out by the charge nurse in the event of a disaster.  An areawide disaster drill scheduled for Aug. 20 will include more than just the ER this time, Bryan said. By involving the hospital in the disaster drill, 50 patients will be taken to the ER and moved into the hospital as if the scenario were real. “It’s time to start thinking about what you would do if your rooms are full and you are getting more,” he said. Action OI information It is once again time to submit Action O-I data. This is for the quarter that ended June 30. The data is due to be in the system by Aug. 20. Additionally each area is asked to verify its Characteristic Survey Questions. This is a Solucient requirement that will be required each fiscal year ending quarter for all institutions.  Pam Marek has scheduled the training room for any additional needs during the submittal period for anyone who needs a data entry refresher or would like to continue creating reports from Action O-I data. Action O-I classes in 220 Clinical Science Building for Data Collection and Reporting. Classes begin on the hour and the half hour—2 to 4 p.m., Aug. 10; 8 a.m. to noon, Aug. 13; and 8 a.m. to noon, Aug. 18. Incentive plan The draft FY 04/05 incentive plan was recently presented to the management team and input was requested.  A concern was raised regarding the potential for eligible temporary workers to receive a higher incentive amount than permanent employees in the same job categories who have more experience. In view of this, a change was made to the draft incentive plan to allow temporary employees to receive an incentive payment of 1 percent, not to exceed $350. Volunteers Stuart Smith encouraged managers and administrators to make wise use of volunteers to achieve the 3.5 percent margin. Smith encouraged the manage-ment  team to join the volunteers at the team-building social 6:30 to 11 p.m. Aug. 13 at the Pelican Watch Shelter at Folly Beach County Park. There will be food, beverages and beach music.  For details, call Kady Kuder, 792-0858, Susanne Banks, 792-7038, Christine Messick, 792-3120, Judy Garris, 792-3580, or Elaine Rudd, 792-3344.     The Catalyst, Aug. 6, 2004