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Currents Sept. 16
To Medical Center Employees:
Our financial performance did not meet budget projections and we
the year with a loss. In previous Currents newsletters, I explained the
reasons for our financial performance. Our efforts in recent months
have focused upon cost containment by improving operational efficiency
and increasing patient volume.
During the past six weeks much effort has been devoted to align nurse
staffing levels with patient care needs. We have standardized unit
staffing models according to best practices for high quality. This
standardization will enable us to operate more efficiently and contain
costs. I realize the changes involved have been stressful for many. I
believe with experience we will improve our ability to anticipate
volume and flex staff to meet our needs.
In connection with our work to standardize staffing models, we are
reviewing the roles of nurse managers, educators, operations
coordinators (or assistant nurse managers), clinical associates and
clinical administrative support staff. We also are working to
more clearly define and standardize the duties of the charge nurse
We sought to include many in this work to standardize clinical units.
Through standardizing the roles and more clearly defining expectations
of these positions and roles, we will operate more efficiently.
Work has just begun on improving our ability to quickly communicate
shift opportunities (in similar areas) for nursing staff who may not be
needed in their “home” unit. Also, travel nurse staff are being
methodically replaced with regular staff.
Our focus on efficiency and cost containment will not be limited to
clinical units. Work is underway to look at all ancillary, support and
administrative areas. Cost savings opportunities related to supplies
and contracts are also being examined.
Within the next week, I will solicit ideas for cost containment and
operational efficiencies through an online survey. It’s expected this
survey will be open for three weeks. Details will be disseminated soon.
In regard to increasing volume, a number of moves have been planned.
These moves will enable us to take advantage of bed capacity in Ashley
River Tower (ART) and we will have additional capacity as renovation is
completed in the Medical University Hospital (MUH). Moves planned
during the next several months include:
- 8W MUH Oncology/Bone Marrow will move to 5W ART effective
- 2 Center MUH Med/Surg will move to 8 West MUH in September.
- 7W MUH Ortho/Trauma unit will be moved in November to 10W
immediately following renovation; 7W will remain open for Neurosciences
- 9W MUH renovation will be completed in November; 7E MUH
Neuro will move to 9W.
- 7E MUH renovation will begin following move of the 7E Neuro
unit —following renovations, 7E MUH will be occupied by Peds Med/Surg
Next month we will kick off a series of town hall meetings. The
schedule will be announced soon. We will provide a goals update
including our progress in addressing our financial situation at the
town hall meetings.
- 9E MUH is currently under renovation and is expected to be
completed in the February/March timeframe. 7W Neuroscience will then
move to 9E making 9E and 9W Neurosciences units.
Thank you very much.
President for Clinical Operations
and Executive Director, MUSC Medical Center
People—Fostering employee pride
Rees, director of quality
& patient safety, shared an organizational win regarding MUSC’s
success in meeting quality measures for pneumonia care specifically the
pneumococcal vaccinations for patients.
An audit performed in August showed MUSC above the state and national
average for compliance in this area. Efforts were conducted by the
Quality Department and the Nurse Alliance Quality Council chaired by
Lisa Langdale, Center for Professional Development and Clinical
- Employee Perspectives Rollout—Materials are available on
the MUHA LDI Web site under the resources link. Additional rollout
training will be scheduled and announced at a later time.
- Staff are reminded to review their PTO balances.
- Standardization of non-clinical staff orientation
unit/department template—This provides staff with a customizable
template for any department. Imple-mentation of the new form is
scheduled for Sept. 29. Departments with non-clinical staff are to
transition to this form for staff orientation. The form is available on
the HR intranet Web site. For information, contact Karen Rankine,
- Code of Conduct and Compliance—All documentation for new
hire attendance will be entered into CATTS. As a reminder, employees
who are late 15 minutes or more for compliance training are asked to
attend the next session.
Mark Stimpson, HR benefits manager, reviewed the upcoming annual
benefits enrollment period.
Between Oct. 1 and 31, MUHA employees may make changes to their
benefits specifically to an employee’s health plan, increase optional
life insurance, enroll for dependent life insurance, enroll/re-enroll
in the Medical and Dependent Day care spending accounts.
Specific to this year’s plan is the elimination of MUSC Options as of
Jan. 1, 2009. Employees currently in this plan must select a different
coverage or otherwise be automatically switched to the Standard State
Health Plan (BCBS).
Employees are encouraged to make their benefit changes online using the
Benefits-eligible employees will be notified via e-mail regarding open
enrollment information. Hospital employees are invited to attend the
MUHA Benefits Fair on Oct. 15 at the Children’s Hospital lobby.
Additionally, there will be 10 benefits briefings scheduled throughout
October, including late evening sessions. The computer lab will be
available for employees without online access. HR will also be
available to provide one-on-one counseling or schedule department
presentations (by appointment only).
Kim Phillips, Transplant Service Line administrator, emphasized the
benefits to hardwiring AIDET best practices with all staff.
AIDET (acknowledge the patient; introduce yourself, your skill set,
your training and professional credentials; duration with an
explanation of the test and how long it will take to complete; and
saying thank you for choosing MUSC) has proven to be a basic and
effective communications tool between patients and staff. Practicing
AIDET reduces stress and anxiety and can contribute to the healing
process of MUSC patients, according to Phillips.
Mark Daniels, patient care systems team manager (OCIO), gave a report
on the eCareNet project status rollouts. Using a graph chart, Daniels’
update was based on the percentage of work completed from a bed count
- OASIS—Activated as of spring 2008 in the medical/surgical
areas of ART, Medical University Hospital (MUH), Institute of
Psychiatry, Charleston Memorial Hospital (CMH) and Children’s Hospital
(CH). Roll out in critical care areas include ART, MUH, CMH and CH.
- Clinical Documentation Package (ClinDoc)—Activated in
ART,MUH and CMH. Planners have begun the design for IOP. In critical
care areas, roll out was completed in ART and the main hospital under
limited capacity using three out of four forms. The fourth form
(24-hour record, vital notes, etc.) is not currently being used.
- Bedside Med Administration Project (Admin RX)—Activated in
ART. MUH is scheduled to go live in specific areas. CMH also is ready
for activation. Planners have not evaluated IOP or CH. Admin RX
was scheduled to follow the ClinDoc system.
- Horizon Meds Manager Medication System (eMeds)—Activated
since 2006 throughout the entire enterprise (ART, main hospital, IOP,
CMH and CH in both medical/surgical and critical care areas.
Planners are currently assessing remaining ART/Cardiovascular areas and
will schedule activations throughout fiscal year 2009. CPOE is
considered the most complex and least mature of eCareNet’s ongoing
- Computerized Physician Order Entry (CPOE)—3West (ART) is
scheduled to go live Sept. 17.
patient care in a safe environment
Kennedy, outcomes manager with
patient safety and a member of the Interdisciplinary Survey Rounding
team, reported on the progress of Interdisciplinary Survey
Readiness Rounds. The team was created to help with hospital readiness
for upcoming Joint Commission inspections. Kennedy reported on the
team’s findings regarding readiness issues:
- Mayday carts—Forms should be updated for the current month.
Carts should be checked off twice a day for every 24-hour work day
- Medication management—Medications should be current.
Contact Pharmacy regarding any questions.
- Documentation issues—To help meet compliance, charts must
contain a date, time and signature. Time outs, pain assessments and
hourly rounding reports should also be documented.
- Unit personnel file—Update competency certifications and TB
- Environment of care—Issues with linen that is not properly
placed properly marked bins. Inappropriate items in clean linen rooms.
Finally, Kennedy urged all staff to review the list of top 10 standards
that can make/break a survey. Currently, the medical center is
preparing for a behavioral health extension survey (IOP-Seasons
Psychiatric Intensive Out-patient and PHP—McClennan-Banks) and the
triennial survey for the main hospital behavioral health survey
(anytime between March 2008 to December 2009).
- Hallways—Items, especially chairs, should be removed from
hallways. Unattended items left in hallways longer than 30 minutes will
- Carol D. Brown has joined Decision Support Services as the
new ANSOS coordinator since Sept. 2. Brown came from the Department of
Pediatrics and also worked at a competing facility where she gained
experience in the installation, testing and training for using ANSOS.
- The next communications meeting is Oct. 7.
Friday, Sept. 19, 2008
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