To Medical Center Employees:
At the May 19 communications meeting Annette Drachman, J.D., MUHA
Director of Legal Affairs, updated the management team on four
important new policies. These include a new Identity Theft Policy;
Conflict of Interest Policy; Professional Relationships Policy; and
Conflict Management Policy.
The Identity Theft Policy applies throughout MUSC in compliance with
federal and state law. This policy addresses the protection of
information such as patient accounts, payroll information, social
security numbers, credit card information, medical records and other
sensitive information. The policy will be posted on the intranet right
away and be effective immediately. Training and education will be
provided. Additional policies will be revised to support and implement
The Conflict of Interest Policy was recently approved by our Board of
Trustees and, like the Identity Theft Policy, applies to all MUSC
components. We have long been covered by the State Ethics Reform Act,
but this new policy serves to bring greater clarity to the ethics law.
It also ensures for our fulfillment of a relevant standard required by
our accreditation body, the Joint Commission. Among other things the
policy requires disclosure of conflicts or potential conflicts of
interest. We will provide training and additional communication on this
policy and it will be posted in multiple locations in the near future.
The new Professional Relationships Policy applies to MUHA and also has
been adopted by the College of Medicine. This policy might be viewed as
an extension of the Conflict of Interest Policy and focuses
particularly on employees’ interactions with organizations (e.g.
vendors) that have business or financial relationships with the medical
center. Among other things, the policy prohibits accepting gifts,
meals, entertainment, travel and so forth that may influence or appear
to influence performance of duties. Adoption of similar policies has
become a common practice among academic medical centers throughout the
nation. This policy will be posted in the days ahead and will become
effective immediately. Additional training and communication will be
The Conflict Management Policy is a MUHA policy and is required by a
Joint Commission standard. This policy provides additional structure to
the “old” conflict management practices coordinated by Human Resources.
The purpose is to provide a methodical process to resolve conflict and
ensure patient safety and quality of care are “not affected by
interpersonal or interprofessional differences.” The policy will be
posted and will be effective right away.
Thank you very much.
W. Stuart Smith
Vice President for Clinical Operations
and Executive Director, MUSC Medical Center
Start spreading the news At Your Request Dining Services will soon be available at the University Hospital.
To get everybody acquainted with this program and help better serve MUSC
patients, introductory classes for all nursing staff will be held.
Sessions will last approximately a half hour
and will be held in Room 107, Colbert Education
May 21 - 2 pm
May 22 - 2 pm
May 26 - 2 pm
May 27- 2 pm
May 28 - 9 am and 2 pm
May 29 - 9 am and 2 pm
People—Fostering employee pride and loyalty
Frazier, administrator for facilities and capitol planning, addressed
recent and planned renovations and planned projects throughout the
medical center. Major projects completed include the opening of ART
(February 2008); BMT, relocated to 5W; ART (November 2008); 10W
(November 2008); 9W (November 2008); Pediatric ED (November
2008); 9E (March) May’s DDCICU bed expansion (in progress).
Other projects started this spring include 7E, STICU/9C/CTICU,
university hospital cafeteria (two phases—dining area and servery;
Subway relocation and Pizza/A la Carte renovation (by November).
Current and planned projects include IOP inpatient bathroom renovation
and other patient care upgrades; 5th floor Surgery and procedure areas;
Children’s Hospital; Pharmacy (clean air renovations—multiple stages
from June to December); Sterile Processing Department move some
activities to ART and renovate remaining space at Children’s Hospital;
university hospital bi-plane areas (third floor); NNICU nursing
station; ART stress lab; Gamma Knife, DeAerator replacement; Rutledge
Tower transformer/electrical distribution; paint and patch projects,
plus other activities.
HCC NCI designation campaign
Alex Sargeant, Business Development & Marketing Services
advertising director, reviewed the communications campaign for Hollings
Cancer Center’s (HCC) National Cancer Center Institute (NCI)
Since March, Sargeant and his team have utilized public relations,
op-ed pieces, statewide public information announcements, physician
communications, internal communications, etc. The campaign’s goal was
to promote HCC awareness, relate the importance of achieving NCI
designation, increase appointments and referrals for local, statewide
and regional patients, etc. Initial reports from the referral call
center already show an increase in physician referrals to HCC.
Smoker rates/MUHA health insurance
Mark Stimpson, MUHA benefits manager, addressed managers about changes
for smoker rates for state health insurance beginning January 2010.
According to EIP, the state agency that oversees MUSC’s health
insurance plans, smoking-related illnesses contribute about $75 million
to additional in costs. These increases will affect insured, benefits
eligible employees and their insured dependents. Insured employees and
their dependents will need to attest and certify their tobacco use by
Nov. 15, otherwise their health insurance premiums will increase by $25
per month (surcharge is not levied per person). Certification can be
found under “forms” at the MUHA HR Web site or can be conducted online.
Employee’s benefits identification number is required.
Tobacco use is defined as cigarettes, cigars, pipes, snuff or chewing
tobacco (not nicotine gum). Subscribers to the Standard, Savings and
Blue Choice, plus CIGNA HMO may participate in the Free & Clear
Quit for Life Program, 1-866-QUIT-4-LIFE (784-8454). Employees who
successfully quit for six months may submit their certification at any
time and the surcharge will cease.
For information or to schedule a presentation, contact Stimpson at email@example.com or 792-0826.
Quality—Providing quality patient care in a safe environment
Kennedy, Outcomes & Quality Management/Patient Safety and a member
of the Joint Commission Survey Readiness Rounds team, began a
comprehensive review of the 2009 National Patient Safety Goals (NPSG)
and best practices.
NPSG #1—Improve the accuracy of patient identification
Use at least two patient identifiers when providing care, treatment and
services—Identify patients visually, audibly and by wristband on the
Eliminate transfusion errors related to patient misidentification—staff
should conduct this adjacent to the patient; labeling of all blood
products should not be removed.
American Hospital Association wristbands use a color code system to
help identify patients: yellow (fall risk); red (allergy) and purple
(code status—advance directives, DNR, etc.); Staff are reminded to
check patient’s charts and not write status on the patient’s wrist
Review of NPSG metrics
The team continues to collect data through employee interviews and
surveying patients for feedback in order to make recommendations.
Kennedy reminded employees that policies are not put in place to make
people do more; they’re created because others have worked together
through interdisciplinary projects to arrive at
solutions/recommendations that help employees avoid medical errors in
McAllister is the new business manager of the Heart & Vascular
Center. McAlister was formerly business manager of Oncology Services.
- The next meeting is June 2.
Friday, May 22, 2009