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Currents

To Medical Center Employees:

We had an unannounced JCAHO Point of Care Testing survey conducted
March 27 through March 30. I want to thank everyone involved for your dedicated efforts which resulted in a highly successful survey involving the “tracer method.”Dr. Kim Collins, medical director for Point of Care Testing, did an excellent job in summarizing the hard work by all concerned in her letter to Marilyn Schaffner, administrator of clinical services, which is included below newsletter.
 
On another matter, recently the Quality Council endorsed appointment of an Environment of Care (EOC) Performance Improvement multidisciplinary team representing concerned areas throughout the Medical Center and chaired by Chris Rees, Performance Improvement Manager. The purpose of the team is to develop an effective structure to resolve issues that have continued to appear on our monthly internal EOC Survey and to reduce cycle time for resolution of identified deficiencies. The team will review current EOC performance indicators, develop new performance metrics as needed and update our monitoring system for quarterly reports to the Quality Council. A subset of the multidisciplinary team will take part in routine rounds designed to take immediate action and assure follow-up.
 
In last week’s Currents newsletter I shared a brief update on the Leadership Development Institute (LDI) recently attended by nearly all Medical Center supervisors responsible for hiring and performance evaluations. I also summarized the Nine Principles of high performing organizations as discussed by our Studer Group coaches at the LDI.
 
Currently our Studer Group coaches are training team leaders of our Service Teams, Leadership Development Teams, and Leadership Evaluation Team. In the months ahead we will be populating the teams as we get our “MUSC Excellence” initiative in high gear.
 
We are also now in the process of realigning our MUSC Excellence goals under five pillars representing people, service, quality, finance and growth. Our goals themselves will not change, but the methods we use to align our goals, values and results will change. Our goals will continue to focus upon being recognized as the employer and provider of choice, quality and patient safety (including fulfillment of JCAHO standards), achievement of financial targets, improvement of communication (including information technology) and remaining on schedule with the new Phase I hospital facility. We will adopt new methods to communicate goals and measure progress, enhance employee recognition and reward, and improve customer service and operational efficiencies. This will involve a “process” over time and will not be an “event”. We will be developing a communication plan to keep everyone abreast of our progress.
 
Thank you very much.

W. Stuart Smith
Vice President for Clinical Operations
and Executive Director, MUSC Medical Center

Marilyn (Schaffner),
As medical director for Point of Care, I want to take this opportunity to express my gratitude and pride in the individuals who orchestrate and enable the success of this hospital service. I am convinced that such a large POC service would be absolutely impossible if it weren’t for the behind-the-scenes efforts 365 days a year of the laboratory team. It has been an eye-opening experience to see exactly what goes on in order to make bedside testing a reality.
 
As a physician, I previously took for granted that my part in a certain POC test amounted to only a fraction of the test menu. Now that I am in a position to see the massive details involved, I am most appreciative that we have the expertise at MUSC to improve patient care and safety. 
 
Again, I am praising the laboratory team/staff of POC. In particular Nina Epps, Nancy Reilly and her staff, Sharon Grant, Becky Reynolds, Sarah Furst Hughes, and Pat Wanstreet and her staff.
 
Congratulations of course also go out to other testing sites that fell under this laboratory survey as well as the cooperative nursing staff/nursing support staff.
 
The training, QA, QC, Proficiency testing, CONSTANT trouble-shooting, organization of test menu, investigation of new test menus, investigation of new POC sites, and the list goes on.
 
I know these individuals do not get applauded nearly enough, but they consistently maintain a positive attitude and professional work ethic. I am so proud to be associated with them and our Point of Care service at MUSC.

Respectfully,
Kim A. Collins, M.D.

Education, CarePages roll-out reviewed

Chris Malanuk, Hospital Replacement Project, reviewed the new hospital’s progress since construction began in February 2005. He mentioned that in addition to beginning the application of the glass curtain that will adorn the new bed tower, all steel construction required for the new facility will be completed by the end of April.
 
With the help of Marketing and Business Development Services, a section of steel that will be placed in the final days of steel construction was painted white and will be available for all MUSC employees to sign under the Library/Student Center portico April 6-8. All employees, students, faculty and staff are encouraged to sign the section before it is placed within the new structure later this month.

Education Roll-Out Committee
Laurie Zone-Smith, Ph.D., R.N., Clinical Services Administration manager, explained the new process for education roll-out across the medical center. She introduced the new Center of Professional Development & Clinical Education Resources, which includes Clinical Education-orientation and competencies, the Community Training Center, Education and Information Roll-out Committee, Interpretative Services and Cultural Competency, Patient and Family Education, Data Management, and Nurse Alliance Staff Nurse Leadership.
 
In January, an Education Think Tank evaluated feedback from interviews with staff, managers, directors and administrators and collected recommended changes to current education practices.
 
A large interdisciplinary group of MUSC educators evaluated the feedback and redesigned a new structure, process and validation for education at the Medical Center.  Zone-Smith explained a matrix educator reporting structure aligned with the unit manager or division with a focus on specialty area and centralized education needs. Streamlining committee structures, the LEAD team and Clinical Education Council were retired and the new Education Roll-out committee was formed.
 
The existing MUSC staff and patient education committee structure in each of the administrative areas remain and include the IOP Clinical Education Council and Patient and Family Education Committee, the Ambulatory Education Resource Committee (ERC- Clinical and Patient Education), the Main (Adult, CH, HVC, CMH) Clinical Services Patient Education Committee, the Division Education Boards, Unit Educator Councils, the Nurse Alliance PERL Councils (Practice, Education, Research and Leadership), and Division and Unit PERL councils.
 
The purpose of the Education Roll-Out Committee is to serve as the one dissemination point for standardized messages across the organization for patient care or patient contact staff. Centralized and decentralized unit educators, unit education liaisons and program based educators from all clinical units and at least one rotating manager/nurse manager will come together to receive and disseminate to their unit staff education and information topics.
 
Units supporting clinical functions are encouraged to review agenda topics to determine applicability in their areas and attend the Roll-out Committee as appropriate. Possible topics include regulatory/accreditation issues, hospital/organization committees, competencies/training, programs, policies, procedures, products, forms, and pre-printed clinical orders. This committee is one of many ways an owner may choose to disseminate information to staff at the unit level.
 
For staff education or information dissemination, call 792-2409 to add an item to the agenda. The owner of the idea then completes a Topic Roll-Out Request form and Clinical News You Can Use form. The owner is then asked to determine if the topic is routine or urgent (STAT). If it is routine, the topic will go on the committee’s agenda within 45 days. The owner then presents the topic to the committee, including target dates and the topic itself. The committee then reviews the topic, makes any necessary modifications, and approves plan. It is posted to the Web and sent to all unit managers. It is disseminated to appropriate unit/department staff by the Roll-out committee membership. If the topic is considered urgent, or STAT, it is sent via e-mail to educators in less than 45 days and copied to managers with a STAT notice. It is added to the next monthly agenda where it will be presented by the owner. Its calendar dates for roll-out, the topic itself and Clinical News You Can Use are posted to the web. The STAT review group reviews the STAT criteria which requires and administrator’s signature and either approves or sends to a routine track, whichever is necessary. Both STAT and routine topics will be followed up with a validation education check three months post- dissemination. The Committee sends the topic list to the unit manager/designee to validate and to decide if more education and/or retraining are needed on the particular topic. If needed, the process for staff education on a particular topic begins anew. 
 
The first Tuesday of every month the Roll-out Committee agenda will be presented at the Communications meeting for information. The April agenda includes: blood collection tube changes, vital sign audits, recipe card for nursing report, adult oral care policy, alternative distribution plan for insulin and the training calendar. The Education Roll-Out Committee Web site can be found at http://www.musc.edu/clined/edrollout/index.htm.

CarePages Roll-Out
Dave Bennett, Marketing and Business Development Services, introduced Carepages, a Web page program designed to bring families and friends together during times of need while a patient is in the hospital. Through the GetWellNetwork in the Children’s Hospital, patients, friends and their families can create and manage personal, secure Web pages that serve as virtual gathering places to provide emotional support, patient updates, pictures and messages. These pages are considered HIPAA exempt because all content is provided and posted by the patient, their family, or friends.
 
Some of the benefits of the program include increased patient satisfaction, family connections over distance and time, reduced call volume, and it offers an easy way to recognize outstanding staff members. To get started, visit http://www.carepages.com/musckids.
 
CarePages also provides patients and their families with an opportunity to thank outstanding staff members through an easy online form. The form is forwarded to a designated hospital administrator who in turn will distribute CareCompliments to recipients in recognition of great customer service.
 
The CarePage service is hosted on TLContact’s servers and customer service support is available at (866) 981-4900, 9 a.m. to 7 p.m. Monday through Friday (EST) in English and Spanish. Online, patients or family members can receive a guaranteed response to their customer service question within four hours in the next business day.
 
All privacy practices are reviewed and certified by TRUSTe, and TLContact cannot reveal details about membership information without expressed consent from the users. All visitors have full control over their personal information, as outlined in the certified privacy policy. In addition, patient information is not used for any marketing purposes and is not provided to the hospital other than in aggregate patient usage statistics. All members create a username and password during registration to create or visit any CarePage, and standard access is enforced by creating a specific CarePage name and signing in each time. There is restricted access for ultimate privacy, which requires the CarePage manager to approve every visitor. Other security and precautionary measures include:
  • TLContact’s database is secured physically and digitally.
  • While it is highly unusual for members of a CarePage to post inappropriate updates or messages, TLContact has safeguards in place to ensure that such violations do not go undetected.
  • TLContact runs private, protective software program daily on active CarePages, searching for possible abuse keywords including, but not limited to the hospital name, doctors, etc.
  • TLContact staff members review messages flagged by software.
  • If a CarePage contains any defamatory, libelous, or slanderous messages, the CarePage manager is reminded of the terms of service and has the opportunity to remove such material or the CarePage is shut down.

Announcements
  • Peggy Thompson, Patient Accounting, read two letters from satisfied customers highlighting the hard work and dedication performed by Patient Accounting employees.
  • Ralph Greene, Hospital Fiscal Services, revisited the Medical Center’s timeline for paperless pay stubs. Beginning with the April 26 payroll distribution, pay stubs can be accessed via the web. Those employees with no record of an MNA password will receive a letter with a password and instructions to use it. Employees with a password that has timed out or that has never been used will also be notified to activate their password to access future pay stubs. Reminders about the online access to pay stubs will be sent through the beginning of June to remind staff of the switch to online pay stubs. June 7 will be the last paper pay stub period.
  • Dave Neff, Ambulatory Care Services administrator, introduced Maggie Thompson, the new Ambulatory Care manager for Service Excellence. Thompson will initially focus on the management of the Press-Ganey Patient Satisfaction Survey Program and will also help plan the roll-out of the MUSC Excellence Program in the outpatient clinics. Thompson hails from Mead Westvaco where she worked as the Information Technology Communications Manager. She currently serves on the MUSC Children’s Hospital Parents’ Advisory Council.

Friday, April 7, 2006
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 catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island papers at 849-1778, ext. 201.