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Currents June 16

To Medical Center Employees:
At the June 16 communications meeting, three employees of the month were announced including Mike Norris, Lead Technician, Emergency Department; Latasha Ellis, Commercial Collector, Hospital Patient Accounting; and Kevin Satterfield, EEG Technician, Clinical Neurophysiology.
Norris was recognized by a physician for his exceptional clinical observation skills which resulted in saving a patient’s life. Satterfield was recognized for numerous acts of kindness and going the extra mile for patients, including personally delivering an elderly patient’s cane to a nursing home located across town.
Ellis was recognized for coming to the aid of a pregnant woman who was waiting on the street curb for a cab to take her over to the main hospital. Ellis drove the patient to the hospital. As we celebrate the acts of these outstanding employees, I am reminded that everyday employees throughout MUSC are going the extra mile with providing compassionate care and service.
Steve Hargett, MUHA Controller, updated the management team on our financial status as we approach the end of the fiscal year (FY). All indications are we will end the year with a small positive bottom line and an improved cash position. I attribute this turnaround to focused efforts throughout the medical center. We will begin FY 2009/2010 in a much better financial position. Additional details are included in this newsletter.
Thank you very much.

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

People—Fostering employee pride and loyalty

  • Mike Norris, R.N., in  the Adult Emergency Department, was recognized for saving a patient’s life during a routine transport of a patient from 1W. Norris alerted other medical staff to the patient’s changed condition, which led to more tests and medical intervention. Norris is praised for his alertness and clinical sense/skills in the care of that patient. (by Sandy Gould)
  • Tasha Ellis, a collector in Hospital Patient Accounting and Revenue Systems, assisted a pregnant woman to University Hospital following a medical appointment at the MUSC’s Cannon Place building. Ellis helped transport the patient to the main hospital. (by Peggy Thompson)
  • Kevin Satterfield, an EEG technician in clinical neurophysiology services, was honored for delivering outstanding customer service and responding to the patient/patient’s family’s needs.

Meredith Strehle, team chairperson for the MUHA Excellence’s Rewards and Recognition team, praised the work of these employees, as well as their managers, for recognizing and nominating these individuals as workplace examples of MUSC Excellence. She encouraged managers and directors for their support in recognizing model employees and physicians throughout the organization by nominating them via the MUHA intranet.
Starting June 26, nominations for Employee of the Year will open. Nominations and related information can be submitted via the MUHA intranet.

HR update
Helena Bastian, MUHA HR director, thanked employees for participating in the first training session of SuccessFactors, the medical center’s new performance management process.

  • SuccessFactors – Managers, supervisors and designated personnel may still register for training via CATTS (participants should verify if a session is full prior to registering). The next training session for super users is June 18 and sessions will extend from two to three hours.
  • SuccessFactors updates — managers to update employee job descriptions and supervisor tree to define reporting relationships. RN templates (RN I, RN II, RN III) have been updated as per Joint Commission HR standards regarding nurses who oversee students (excluding residents and/or medical students) when they provide patient care, treatment and services as part of their training.
  • July 4 holiday – Observed on Friday, July 3. Holiday shift differential will be authorized for an eligible nonexempt (hourly-paid) employee whose work shift begins during the actual holiday. (I.e. shift beginning 7 a.m., July 4 [eligible] and shift beginning 11 p.m., July 3 and ending 7 a.m., July [not eligible]). Refer to HR Policy #15, Compensation, for more details.
  • July 6 Orientation – PEARS are due June 30 because of the upcoming holiday.
  • Online Posting — Effective July 1, quarterly postings and the requirement to get final hire approval will be discontinued. PEARS must still be submitted for new hires.
Quality—Providing quality patient care in a safe environment

Lois Kerr, MUSC Joint Commission consultant, shared results from the Patient First Action Plan audits. She reminded managers that the Patient First tracking audits and Stand down Wednesdays initiative (begun as of June 3) are two separate efforts now conducted throughout the organization.
Kerr reviewed results from initial reports reported by the inpatient manager teams: Entries in the medical record are signed, dated and timed (84 percent compliance; goal is 90 percent); Verbal orders signed/dated and timed within 48 hours (77 percent); Nursing admission database is completed within 24-hours of admission (86 percent); Plan of care is interdisciplinary/appropriate to the patient (96 percent); Staff/patient food is segregated in refrigerators (97 percent, goal is 100 percent); All medications in refrigerators are labeled and includes dates according to policy (96 percent, goal is 100 percent).

  • Outpatient/EDs – Appropriate consent is documented in record (88 percent). There is still some confusion about general and informed consent. Management is working to clarify this issue.
  • Procedure Areas/ORs – Time Out is completed and documented on standardized form. (80 percent). Need to reemphasize Time Out procedures and proper use of standardized form; Operative/procedure progress note includes all required elements (73 percent). Synopsis report for next caregiver while report is being transcribed and typed. Report should include specific elements including estimated blood loss during procedure (must indicate with N/A or a number)
  • Administrators (rounding) – Corridors not clean and obstructed (80 percent); Medication carts secured (75 percent); and Employee competency folders (57 percent).

The tactical SWAT team (composed of service line directors) will meet to review data and findings. Kerr thanked all managers and staff for participating with these audits. Organizers are now personalizing similar audits in specific departments (pharmacy and radiology).
National Patient Safety Goals
Carl Kennedy, Outcomes & Quality Management/Patient Safety and a member of the Joint Commission Survey Readiness Rounds team, continued his review of the 2009 National Patient Safety Goals (NPSG) and best practices. He reviewed elements of performance goals related to NPSG #2: Improve the effectiveness of communication among caregivers. It states that good communications is key.

  • Elements of Performance (2.01.01) — For verbal/telephone orders or for telephone reporting of critical test results, the individual giving the order/test result verifies the complete order/test result by having the person record/read back the information to verify the complete order/test result.
  • 2.02.01 — Standardized list of abbreviations, acronyms, symbols and dose designations must not be used within the organization. Staff should be aware of trailing zeroes; implement “do not use” list for all medication-related documents that are handwritten or entered as a free text into a computer. Hospital does not include any abbreviations, symbols and dose designations identified as not to be used on preprinted forms.
  • 2.03.01 – The organization measures, assesses and takes action (if needed) to improve the timeliness of reporting and receipt of critical tests, test results and values by the responsible licensed caregiver. The hospital defined these. It also defines the acceptable length of time (30 minutes) of the availability of critical tests/results/values and receipt by a licensed caregiver. See the revised Policy C-80, which defines these tests as by cardiology, radiology and laboratory services.
  • 2.05.01 – The organization implements a standardized approach to hand-off communications including the opportunity to ask/respond to questions. SBAR communications is the hospital’s standardized practice.

(S-What is the current situation? B-What is background? A-What are the assessment factors? R-What are the recommendations). Hand-off is about transferring the care of the patient and not the location (shift change, lunch, break, meetings, etc.). Limit interruptions during hand-offs to minimize the possibility that information fails to be conveyed or is forgotten.

MUSC Patient/Family Shuttle service
Brian Fletcher, clinical services disaster preparedness coordinator and interim clinical manager for Meducare, announced that the MUSC Patient/Family Shuttle will suspend it's service at Charleston Memorial Hospital/McClennan Banks. The service will be available on a will call basis for patients/families. Call 792-7997.  

Finance—Providing the highest value to patients while ensuring financial stability 
Stephen Hargett, medical center controller, reviewed the financial report and continued progress made since last quarter.
Hargett praised the hard work by hospital employees for completing/processing any open and discrepant purchase orders with accounts payable. Fiscal services are currently preparing for their annual external auditors visit in August to confirm the medical center’s financial results for the year.
Through the past 11-month period to May 31 FY2009, the medical center is currently in the black with more than a $500,000 gain. Hargett reminded managers that the medical center has taken the prior year hits this fiscal year. He emphasized that leadership has put all processes in place to insure we won’t have repayments in future years.
Census year-to-date has averaged  520 compared 497 through 11 months of FY 2008. Hospital surgeries were up by double-digit increases and productivity is at 6.9 FTE per adjusted discharge year-to-date compared to last year’s 6.97.   MUHA’s unrestricted cash balance and days cash on hand as of May 31 shows an increase of $20.7 million and 8.8 days cash.
Hargett predicts a good cash number for our annual financial statement on June 30.

The next hospital communications meeting is July 7.

Friday, June 19, 2009

The Catalyst Online is published weekly by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. The Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, Editorial copy can be submitted to The Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.