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Currents To Medical Center Employees: At the Jan. 11 communications meeting, Maureen McDaniel, manager of Bed Control and the Admit/Transfer Center, gave an update on progress being made by the Bed Capacity Task Force. Her comments are highlighted below. In recent years our census has steadily grown. Our Emergency Room volume and transfer requests have increased. The demands on our system have dictated that we improve processes to efficiently move patients through the system from admissions to discharge.  The Bed Capacity Task Force has done an exceptional job to date in identifying opportunities to improve methods of care delivery, procedures and communication systems. Virtually all Medical Center employees will be affected in some fashion and everyone’s support is needed. A “cultural change” will be needed to achieve the improvements needed. Other hospitals throughout the nation have observed similar increases in patient volume and congestion. As indicated in an August 2004 Currents newsletter, the JCAHO approved a new “patient flow” standard that will be effective this month. The purpose of the standard is to focus on patient flow from assessment for possible admission to discharge, and to identify ways that efficient patient flow impacts patient safety and quality.  Thank you very much.   W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center Bed occupancy, admissions increase  Beginning with an overview of  “Where Have We Been?” ATC manager Maureen McDaniel, presented “Bridging the Bed Capacity Gap” by demonstrating the growth in occupancy rates and admissions during the past five years. In every unit, in every area of the hospital, the numbers increased substantially. Answering the question, “What Have We Done?” McDaniel described the functions of the Bed Capacity Task Force that was formed and listed its members, identified opportunities to better deal with turnover of patient discharges and admissions, formed the ATC and described the role of the Complex Discharge Team. So, “Where are We Going?” actions  include: Piloting a physician communication tool that will notify the ATC of anticipated discharges. Development of a Web site to notify the organization of real-time bed capacity.  Standardization process will include a goal of 30 minutes from entering the time a patient leaves the room and when the ATC is notified by computer. Assessing the “Boarder” patient status and making recommendations for expediting of their care. Developing a standardized communication process for the organization whereby on the last week of each month the monthly minutes of the Bed Capacity Task Force will be sent to managers, directors and medical staff. Presentations to MEC, Quality control, and Operations. As to “What Can You Expect?” McDaniel said to expect input from the front line staff in the form of focus groups, observations on the units, listening to suggestions, a shift in discharge time to earlier in the day, and elimination of overcrowding in the Emergency Department. Tactical Plan Rosemary Ellis presented the Improve Care, Quality, Safety and Effectiveness portion of the Tactical Plan by describing four major initiatives and their respective workgroups. The initiatives are clinical pathways, improvement processes, key clinical performance indicators and patient safety oversight group. Clinical Pathways—Status: to be initiated this month. Objectives:  q  Review comparative benchmark for opportunities. q  Create teams to investigate identified areas, develop pathways, incorporate safety practices into pathways. q  Develop methodology to track variance, aggregate data and report back to applicable teams for improvement opportunities. Improvement Processes—Status: Second meeting to develop an online structure designed to assist rapid improvement. Will be a searchable tool. Objectives: q  Identify and implement processes to reduce response time from problem identification to implementation of a fix. q  Dashboard of key quality and safety performance measures. q  Continue to develop a culture that supports “safety mindedness.” q  Identify and act on opportunities to increase coordination of various safety and quality improvement initiatives. q  Evaluate effectiveness of current orientation and training processes to build basic organizational competency in RCA and FME among management team and ultimately front line staff. Key Clinical Performance Indicators—Status: Quarterly report developed and initially disseminated to department chairs; upcoming report disseminated to department chairs and administrators. Objectives: q  Identify valid and reliable internal and external data sources. q  Create and disseminate comparative report to clinical and administrative leaders for opportunity identification and action. q  Provide resources to support data drill down and analyses. q  Create forum to share success stories and lessons learned. Safety Oversight Committee Objectives: q  Implement processes and procedures that integrate evidence-based practices that prevent the occurrence of hospital acquired complication. q  Identify performance indicators to determine utilization of evidence-based practices. q  Develop monitoring and feedback mechanism  Ellis said that the Oversight Committee’s goal is to come within 90 percent compliance with evidence-based practice for prophylaxis of complications of care. She added that performance measures will be related to the processes of care. Announcements Sue Pletcher, director, Patient Access Services and Health Information Services, announced that Colleen Garry, R.N., has joined the Medical Center as the program coordinator for the Clinical Documentation Improvement Program. Reece Smith, director, Compliance and Revenue Systems, announced that Kerry Gasperson, manager of revenue systems and her department, have been reassigned to the Compliance program.  This reassignment does not involve a change in duties, but is intended to more appropriately align compliance-related functions. Kelly Shaw accepted the Compliance office manager position.  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.