To Medical Center Employees:
At the Feb. 24 management communications meeting Steve Hargett, MUHA controller, updated the management team on the medical center’s financial status. His comments are included in this newsletter. We have made good progress most recently due to our high patient volume and cost savings initiatives. We expect that we will not end the year with a deficit.
 
As mentioned in a previous Currents, the State Department of Health and Human Services’ reimbursement formula for Medicaid resulted in overpayment of hospitals throughout the state for past fiscal years (2004, 2005 and 2006). This hit us particularly hard due to the fact that nearly 20 percent of our revenue is Medicaid. We have to repay these overpayments. We repaid for 2004 last year, and this year we are repaying for both 2005 and 2006, which amounts to approximately $22 million. Next year we will be in a much better position to achieve a reasonable financial margin once we have this behind us.
 
On another matter, at the communications meeting Gwen Brown, business operations coordinator, Ambulatory Care, and member of the MUSC Excellence Behavioral Standards Team announced the Standard of the Month for March is the 10/5 rule. The 10/5 rule means we are to acknowledge a person 10 feet away by making eye contact and smiling and at five feet away we should say hello.
 
This 10/5 rule can be viewed as the first step of AIDET. Some areas are doing a great job in consistently using AIDET while others need to refocus their attention on taking it up a notch. AIDET training can be arranged for departments by contacting Karen Rankine, education and development manager, at rankinkh@musc.edu or 792-7690.
 
Finally, please remember the next series of town hall meetings are scheduled for March. In addition to the published schedule, some town hall sessions will be conducted as part of staff meetings for large departments.

Town hall meetings
The town hall meetings will be held Monday, March 9, 3:30 p.m., IOP auditorium; Tuesday, March 10, 2 p.m., 2W amphitheater; Wednesday, March 11, 7:30 a.m., 2W amphitheater; Friday, March 13, 10 a.m., ART Auditorium; Monday, March 16, 11 a.m., SEI Auditorium; Tuesday, March 17, 11 a.m., ART Auditorium; Wednesday, March 18, 11 a.m., SEI Auditorium; Thursday, March 19, 3 p.m. SEI Auditorium, Monday, March 23, 3 p.m., ART Auditorium; and Tuesday, March 24, 11 a.m. IOP Auditorium.
Thank you very much.

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

People—Fostering employee pride and loyalty

Brian Fletcher, R.N., Clinical Services Disaster Preparedness coordina-tor, reviewed some of the 2009 Joint Commission emergency management requirements that will affect clinical and non-clinical areas. Fletcher outlined the attestation requirement worksheet; change/review notice sheet; emergency supply cabinet checklist and clinical interventions.
 
Joint Commission requires that 90 percent of staff understand their role and responsibility during an emergency event. To verify this, staff should read the emergency operations plan and submit a signed attestation sheet, which should be placed in the departmental emergency response plan notebook. Also any changes made to the departmental notebook should be entered on a change/review sheet and placed in the notebook. During the hospital’s Joint Commission Survey Readiness Rounds, staff found that unit emergency supply cabinets had missing/damaged equipment. Staff should conduct a monthly review of their emergency supply inventory and restock items using a  checklist.
 
Finally, the clinical intervention for failure of equipment/utility system failure should be placed in Appendix I of the Departmental Emergency Response Plan. The plan should be referred to at anytime there is a system failure (power, medical gas, etc.) within the unit/department. All worksheets and checklists are available via the disaster toolkit on the MUSC intranet.
 
Other information to roll out in March includes the medical center’s new bomb threat and mass casualty incident plans.

HR update

• Primary Source Verification— Renewals for staff must be verified prior to the expiration date.

• New hire references—HR conducts employment, education and criminal background checks. HR contact the hiring manager should there be an unfavorable reference/discrepancy. For internal hiring/staff transfers, managers should communicate with the employee’s previous manager. Call MUHA HR for further assistance.

• HML Training—Roll out of the High/Middle/Low performance training is scheduled March 3 during MUHA town hall meetings, 1 p.m. and 2:30 p.m., Baruch Auditorium. An HML panel discussion is scheduled at 10 a.m., April 6, March 24 and 1 p.m. (one hour), Rm. 628 Clinical Sciences Building.

• HR Training—Personnel File Review, 1 p.m., March 9; Selecting Talent, 8:30 a.m., March 11; AIDET Refresher, 9:30, March 12; Medical Terminology, 10 a.m., March 18; Management Orientation, March 20, 26 and April 2; Plan for Your Future, 12:15 p.m., March 23; Basic Finance/Financial Planning, 8:15 a.m., March 24; HML, 10 a.m., March 24 and Disciplinary Process, 1 p.m., March 25.
  

Standard of behavior—March
Gwen Brown, Ambulatory Care business operation coordinator, talked to managers about the 10/5 rule as March’s Standard of Behavior. Brown explained that reviewing this rule— making eye contact with people at 10 feet and speaking/acknowledging them at five feet—helps employees refocus on behaviors and hardwires best practices. Brown also reminded managers to continue use of the key word “excellence” as a peer-to-peer cue to follow the standards of behavior in the workplace.

eCareNet update
Mark Daniels, patient support systems team manager, updated managers on projects:

• ECareNet Viewer (OACIS)— Medications (eMAR) view has been revised. Active medications for current encounter is now the default view; Adult ClinDoc data now available; finalizing diabetes/insulin monitoring screens; critical care specific review screens are in development and other tasks are in work queue

• Clinical Documentation Package (ClinDoc)—review/update of Critical Care 24-hour record; data flowing to eCareNet repository; work continues on psychiatry screen designs; plans to review interfaces for physiological monitors

• Bedside Med Administration Project (AdminRX)—live and operational; no changes at this time (follows ClinDoc implementation)

• Computerized Physician Order Entry (CPOE)—Live on three units. Two other units are scheduled to go live and one unit in the implementation phase; orders viewable in eCareNet viewer; current issues include—workflow (procedural areas); order management and managing order set changes
  

Quality—Providing quality patient care in a safe environment
Sharon Dunning, R.N., risk manager, presented information about Joint Commission Survey Readiness Rounds and sentinel events. The Joint Commission defines a sentinel event as something that signals the need for immediate investigation and response. Examples of a sentinel event include wrong site surgery, unintended retention of a foreign object during surgery/procedure; death or major permanent loss of function that is the result of a medication error; fall or trauma occurred in the hospital, etc. The goal is to improve patient care and prevention of future sentinel events. Details are available in the leadership standard 040405 under elements of performance or MUHA’s Policy C-49 “event investigation and analysis.” For survey readiness, staff will be evaluated on compliance to standards; process for responding; interview staff  to sentinel events; and review a completed root cause analysis.

Finance—Providing the highest value to patients while ensuring financial stability
Steve Hargett, medical center controller, presented the financial report stating that the hospital has been making substantial, positive improvements since the last quarter. For the first three months of FY2009, MUHA lost $8.7 million and gained $2.6 million (October to January) resulting in the - $6.1 million loss year to date.
 
The average census during January was 528 patients per day, volume indicators were up with inpatient/outpatient surgeries, ER visits, etc.
 
Last year, costs and productivity averaged $37 million/month (from February to June 2008). Since then, MUHA has implemented cost savings measures such as flexing staff to volume and converting traveler nursing staff to employees that resulted in average compensations costs of $32 million/month.
 
Projection for the June FY2009 is at or close to break even. Finance director John Cooper has been working with state Medicaid personnel that should result in $10 million to $15 million payment for fiscal year 2008 costs.

Announcement
Medically Fragile Children’s Program will close March 31. Children’s Hospital administrator John Sanders thanked Pat Votava, director, and Stephen Goldbold, Children’s Hospital’s business manager, for their leadership and commitment to the program


Friday, Feb. 27, 2009