To Medical Center Employees:
During December we have continued to be very busy with an average census of 557 for the first sixteen days of the month. Also we have continued to have a high volume of outpatient activity amounting to an increase slightly in excess of 10 percent more than last year.
 
It has been close to three years since MUHA kicked off MUSC Excellence. We have made good progress, particularly with improving patient satisfaction. The College of Medicine and UMA and other components of MUSC kicked off MUSC Excellence about a year later and this strengthened our ability to accomplish our pillar-based goals.
 
I want to briefly discuss two MUSC Excellence best practices which we refer to as “MUST HAVES.”  We need to continue to routinely discuss and hone our skills with use of these and other MUST HAVES.
 
Last year one of the MUSC Excellence MUST HAVES rolled out was “High/Middle/Low” (HML) conversations and we will again discuss HML at the next MUHA on-campus LDI. We did not mandate use of specific terminology because some felt the term “Middle” might not always send the right message. In conducting HML conversations, leaders were expected to: clearly express gratitude to high performers for their exceptional work and seek feedback on how to better support these individuals; express appreciation to those who do good jobs, and provide guidance on how to improve in one or two areas; and have frank “adult conversations” with low performers to prescribe what must be done to improve.  These conversations were to have been 90 percent positive with a focus upon standards of behavior and performance.
 
Leaders should conduct HML conversations at least once each year (other than during the formal performance appraisal). (The College of Medicine/UMA is formally rolling out HML at this time). However, HML conversations should be top of mind and should take place anytime as appropriate. Everyone has been very busy and now is a particularly good time for all leaders to express appreciation to staff for jobs well done.
 
AIDET is a simple but powerful MUST HAVE and is the MUHA Standard of the Month for January 2009.  AIDET involves key words at key times for interacting with patients, visitors and others.  The following generally describes the AIDET steps:

• A (Acknowledge)—Establish eye contact and smile;

• I (Introduce)—Name, department, self/skill set/experience, certifications, co-workers, physicians or others;

• D (Duration)—How long will test/procedure/appointment take?; How long will patient need to wait?; How long before test/procedure visit/admission takes place?; How long until results are available?

• E (Explanation)—Why are we doing this?; What will happen next?; What questions do you have?

• T (Thank you)—Thank you for choosing MUSC.

In the course of AIDET we “manage up” ourselves and others. The intent is to make patients and visitors comfortable and to put them at ease. Every step of AIDET may not be needed, depending on the nature of the encounter. We know the consistent use of AIDET increases patient satisfaction. Anyone who needs AIDET training can contact Karen Rankine, manager of education/development, at 792-7690 or e-mail rankinkh@musc.edu. 
 
Calendar year 2008 was particularly challenging with opening of Ashley River Tower and with addressing our financial situation. I want to thank everyone for your dedicated work and compassionate care. Have a happy and safe holiday season.
 
Thank you very much.
W. Stuart Smith
Vice President for Clinical Operations
and Executive Director, MUSC Medical Center

People—Fostering employee pride and loyalty
Helena Bastian, MUHA HR director, addressed managers with the following reminders:

• As of Dec. 17, CATTS converted to NetID login. Employees will login using their NetID.

• Status/scheduled hours—A seven-day written notice is required for employees who have a change in status, scheduled work hours or pay.

• Tuition assistance payment— Requisitions should be sent directly to Payroll and no later than Dec. 19 for payment in the Dec. 31 paycheck. Supporting documentation must accompany the request. Requisitions must be generous. Supporting documentation accompany the request.

• 2008 evaluations—This must be completed and submitted to MUHA HR by Dec. 31.

New employment process

• The South Carolina Illegal Immigration Reform Act (SCIIRA) requires all public employers to register and participate in E-Verify to verify the employment authorization of all new employees effective Jan. 1.

• E-Verify is an Internet-based system operated by the U.S. Department of Homeland Security and the Social Security Administration.

• MUHA HR will verify information from an employee’s I-9 form utilizing E-Verify within the first three days of employment. More information will be presented at a later time.
  

Standard of Behavior—January
Meredith Strehle, marketing and service excellence manger for Children’s and Perinatal Services and co-chair of MUHA Excellence’s Standards Team, reviewed January’s standard of behavior  —AIDET. This month’s standard poster of AIDET highlights the IOP team’s best practice. Another successful AIDET best practice tool is the AIDET cart used by the Children’s Hospital and adopted by the adult hospital service team. Additionally, the standards team will be conducting AIDET rounds throughout hospital units to talk and help educate staff about the monthly standards and where information can be found.

eCareNet update
Mark Daniels, patient support systems team manager, Office of CIO, reviewed
the status of projects with the hospital’s clinical information systems:

• Bedside Med Administration Project (AdminRX)—All adult medical-surgical and non-critical units have been activated, with exception of TCU, which moved into the main hospital. Plans are to activate the TCU system very soon.

• Computerized Physician Order Entry (CPOE)—The system is live in ART’s 3West, 5East and 5West as of Dec. 9. Daniels thanked Nicole Painter, Kathy Burt and their staff, plus the nursing informatics team for their hard work. The work team’s goal is activate the program in all ART non-critical care units by June 30.

• Clinical Documentation Package (ClinDoc)—Currently building new flow sheets (diabetes and pain). The team is working on implementing a notification system featuring work lists and reviving the use of notification rosters (used previously with OACIS). Focus is to synchronize more of this ClinDoc data with the OACIS system to develop new views.

• ECareNet Viewer—Currently refining the first revision of the system’s medication view (EMAR) working with physicians, nurses and pharmacists. The team also has introduced new screen views featuring admission assessment data from McKesson’s ClinDoc system. Work also is being conducted to improve notification rosters and critical care area’s view of their data working closely with physicians and nurses.
  

Quality—Providing quality patient care in a safe environment
Brian Fletcher, R.N., MUHA clinical disaster preparedness coord-inator, reviewed details with Joint Commission’s survey readiness rounds in the medical center. Fletcher spoke about the Joint Commission’s focus on environment of care and emergency management areas. 2009 Emergency management standards are specific and are attributed from the environment of care Readiness rounds have discovered the immediate need to clear all egress hallways and fire doors from all equipment, computers, medcarts and chairs.
 
Teams have also discovered that doors are also propped open, which is both a fire code and Joint Commission violation.

Emergency management
Supply cabinet inventory—the team found the need to conduct a regular schedule of  inventory checks on a monthly basis. A supply inventory sheet is being developed to help.

Emergency Operation Plan/Disaster Plan—Joint Commission has changed  “disaster plan” terminology usage to “emergency operation plan” or “departmental emergency response plan.”

Location of EOP—confirm place-ment in primary nurses station.

Emergency keys/lighting—not all emergency cabinets are not supported by emergency lighting; recommendations are to attach a glow-stick light to any emergency keys. The emergency keys should hang in an easy to reach location at the primary nurse’s station.

Review of roles during an events—brief review of unit’s emergency plan and specific role for staff during such an event.
 
For information, contact Fletcher, 792-7752, or Al Nesmith, 792-6902.

Announcements
Kathy Wanstall, R.N., is the new manager of 7 West. Wanstall was previously the 8West (5West, ART) nurse educator and is an oncology certified nurse.

Cindy Teeter was named the new director of university compliance office effective Jan. 5. Teeter has been the MUHA HIPAA Compliance officer within Patient Access Services and the Health Information Security Program since August 2007.

Friday, Dec. 19, 2008