To Medical Center Employees:
We have been very busy since October with a high patient census and outpatient activity. Our cash situation remains very poor and we are in the “red” for the fiscal year, but we expect our financial situation to gradually improve in the months ahead as we are able to bring in revenue from the high volume of patient care.
 
Clearly we will need to continue efforts to operate efficiently as we prepare for the future. For example, most recently the State House of Representatives Ways and Means Committee asked the State Department of Health and Human Services to deliver a plan for a 15 percent budget cut for fiscal year 2009/2010. We are concerned about the impact this budget cut could potentially have on Medicaid provider payments which previously have been protected. We will be working with the MUSC leadership, State Hospital Association and others to ensure elected officials understand the possible impact a reduction of Medicaid payments could have on health care for citizens of our state.
 
I want to commend everyone for your dedicated work to provide high quality and compassionate care. While we have implemented an array of initiatives to control costs and improve operational efficiency, our overall patient satisfaction results remain high.
 
The overall patient satisfaction survey results can be found on the MUSC Excellence Web site. I will be discussing our patient satisfaction results in more detail during upcoming communications meetings.

Thank you very much.

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

People—Fostering employee pride and loyalty
Peggy Thompson, director of patient accounting and revenue systems, shared a recent win in her area by reading a letter sent in by a patient thanking MUHA staff for the care he and his wife received during an unplanned visit and recovery at MUSC. The letter praised hospital staff for the care and treatment shown to his wife after being diagnosed with viral spinal meningitis, encephalitis and cerebral edema.
 
The husband expressed his gratitude for level of care presented to his wife and family. “We thank God daily for the healing care demonstrated to us,” he wrote. “We feel sure it was with God’s healing touch that exemplified each of your actions and constant thought for my wife’s overall care.”

Charleston Memorial Hospital update
Dennis Frazier, administrator for facilities and capitol planning, and Sharon DeGrace, R.N., Surgery Acute and Critical Care Service Line administrator, reported on the successful TCU move from CMH to 2C on Nov. 25.  DeGrace thanked hospital and support staff for their help and cooperation with this effort. With the vacating of space at CMH and other areas, Frazier urged managers in need of space to submit their request for space at the Facilities Web page. Frazier and other managers will review space requests and make recommendations.

ShiftSmart update
Elizabeth Perry, manager of MUHA staffing office, hospital supervisors and HOP staff, gave an update on the ShiftSmart program utilization.
 
Perry reviewed October data. In the first four weeks that ShiftSmart was launched, managers submitted 745 shifts, 313 staff applied for work and 70 of those shifts were filled. Perry thanked Michael Irving, Donna Padgette and Yvonne Martin for their assistance.
 
Within the past two months, progress has been made with the program’s data collection tools. Recent data shows an increase in overall participation from two units to 30 units who now use ShiftSmart. Shift needs are now being submitted by nurse managers using ShiftSmart and following the ANSOS scheduling dates. Participants include 20 ASBs, 136 PCTs, 257 RNs and several unknowns (no skill sets were submitted by nurse managers). A total of 713 shifts were submitted by nurse managers between Nov. 1-22 and 286 staff requested to fill these shifts. Data confirm that 124 shifts were filled in November that would not have been filled otherwise.
 
According to Perry, ShiftSmart staff now supplement the HOP staff for hospital staffing needs. Recent data support increased utilization with an average of 40 percent submitted shifts filled by staff via ShiftSmart.
 
Perry currently plans to continue with training and education with staff and managers. An online staff survey is being planned and will be added via a link to the staff ShiftSmart confirmation e-mail in the near future.

HR update
Modifications are being made with to the  organization and clinical orientation schedules effective January 2009. The revised schedule will be posted on the MUHA HR Web site.
 
CATTS will not be available on Dec. 15 and Dec. 16 to convert to NetID login

• Starting Dec. 17, MUHA employees will log into CATTS using their NetID login and password
  

Employee Health New Hire screening:

• Documentation of EHS clearance for new hires is now sent electronically to HR.
  

New hires will no longer receive a clearance form

• Employees can access their immunization and TST records under My Records

• OSHA Respiratory form will be sent to MUSC Occupational Healthy and Safety department

  For information, call Karen Rankine, 792-7690.

Best practices
Bill Moran, M.D., division director for General Internal Medicine and Geriatrics, shared current ideas and best practices in ambulatory care. Since 2005, Moran has chaired the Physician Clinical Directors, a group of 60 medical staff clinical directors to discuss and apply new efficiencies, cost reduction ideas and revenue enhancement efforts that can improve clinical operations.
 
The group meets every few months and evaluates cost-cutting efforts using Practice Partner, patient satisfaction and practice management, etc.With ambulatory care having more than 400,000 visits per year, Moran believes implementing small practice changes can yield big efficiencies. Programs like Gneral Medicine, Family Medicine and ENTs same day/rapid access strategies have been very successful. He shared ideas about utilizing mid-level providers in place of physicians at locations that are running at capacity. Other improvements include tweaking scheduling to reduce overtime, evaluating clinic capacity, room utilization and patient volume, balancing physician services with staffing and balancing physician and hospital charges.

Payroll update
Patty Burn, MUHA Fiscal Services/Payroll manager, related that on Dec. 4-5, MUHA Payroll staff will relocate to its new offices at Harborview Tower, Room 502. Burn assured staff that payroll phone number extensions, fax numbers and staff did not change during this move and remain the same. She told managers that Vickie Nash, who conducts Payroll’s training and Kronos support, also will relocate to the new Harborview Tower location and reassured staff that a payroll employee will remain at the Medical University Hospital location for an interim period until the move is completed.
 
Burn reminded staff that any payroll-related documentation can be faxed, 792-8591, or scanned electronically for submission at any time.
 
Burn and Nash unveiled the new MUHA Payroll Web site to managers. The site features updated news and information including payroll dates, holidays, payroll forms and Kronos timekeeping procedures. Other details include PTO conversion to ESL info and 2008 tuition reimbursement (deadline is Dec. 19, payout Dec. 31). Visit http://mcintranet.musc.edu/hr/payroll/index.htm.

Employee Benefit of the Month
Mark Stimpson, MUHA benefits manager, reviewed the monthly benefit for December, which is supplemental medical leave (SML). Established in 2007, SML is a component of the Paid Time Off (PTO) policy and provides income protection for illness-related absences. Similar to PTO, SML can be used for personal or family illness (doctor’s appointments as well as to satisfy the 24-hour requirement before ESL is accessed).
 
To be eligible, an employee’s ESL balance must have at least 55 hours of ESL prior to the pay period ending Jan. 3. Eligible employees will have up to 24 hours of ESL automatically transferred to their SML bank (not to exceed 40 hours). SML was recently enhanced. Previously up to 12 hours of ESL can be transferred to SML and maximum balance was 24 hours.

Standard of Behavior for December
Cindy Teeter, HIPAA compliance officer, and Standards of Behavior Committee member, reviewed December’s standard for practicing elevator etiquette. It focuses on practicing respect and courtesy by allowing visitors to enter and exit first and self-monitoring of conversations by not discussing patient information.

Education roll out update
Laurie Zone-Smith, Ph.D., R.N., manger for the center for professional development and clinical education resources and interim manager, dialysis and hemapheresis, addressed managers about topics from the Nov. 20 meeting. Topics included the consent policy revision (C-02) informed consent prior to performing epidurals; adverse reaction to blood transfusion; back flushing technique for secondary medication administration; annual competency day templates and checklists and forms update.

Quality—Providing Quality patient care in a safe environment
Maureen Sheakley, PharmD, medication safety coordinator, Department of Pharmacy Services, presented some findings from the twice-weekly Joint Commission Continuous Readiness Rounds. Her focus on these rounds is medication storage and security. Storage includes correct temperatures, expiration dates and environmental conditions. To ensure medication security, medication rooms should always be closed and locked. Patient drawers in the medication carts should be locked, and no medications should be left on top of the medication cart. Sheakley also cautioned staff about unlabeled syringes, unsecured prescription pads, patient labeled medication containers in open trash cans as other risk points that should be corrected. Overall, the hospital and surrounding areas have improved greatly in terms of medication safety, storage and security. She mentioned that newer construction areas include true medication rooms where access to medications has been enhanced. This, combined with new technologies (AdminRX, Smart Pumps, CPOE), has increased medication safety within the medical center.

Announcements

• MUSC Angel Tree Angels are still available for adoption by the MUSC family. As of Nov. 25, more than 1,300 angels have been distributed around the MUSC campus. Angels also can be picked up at the Christmas tree at 2NT, main hospital, outside of the HOP office. Participants can drop off their tagged, unwrapped toy at the annual MUSC Angel Tree Toy Drop Off Event at 11:30 a.m., Dec. 16. Contact Liz Nista, 792-8382, to request angels or for more information.

• Hospital Supervisor’s New Years holiday coverage will begin at 3 p.m., Dec. 31 until 8 a.m., Jan. 2. Staff will resume their regular schedule at 3 p.m., Jan. 2.

• The next meeting is Dec. 9.

Friday, Dec. 5, 2008