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Town hall meeting focuses on preparation, feedback
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Stuart
Smith, vice president for operations and executive director of MUSC
medical center, and organizational managers discussed the following
agenda topics: review of fiscal year (FY) 2010-11 goals and
year-to-date organizational goal results; recognition of exceptional
employees (Employee, Physician and Nurse of the Month winners); Heart
& Vascular Service Line and Pediatric Emergency Department
spotlight; patient survey vendor transition; hand hygiene initiative;
organizationwide employee partnership action plan; health care reform
preparation and employee ideas.
The meeting began with Smith reviewing the medical center’s FY2010-11
organizational goals and results with employees.
 Service—Serving the public with
compassion, respect and excellence
Smith explained the standardized survey tool Hospital Consumer
Assessment of Healthcare Providers and Systems (HCAHPS) which compares
MUSC to other hospitals on the Internet. MUSC’s results for adult
in-patient percentage (9 to 10 rating scale) showed that the hospital
achieved a 77 percent (about the 90th percentile range) rating.
The goal is 78 percent. Meanwhile, outpatient clinics percentage
continues to do well in rankings by meeting the 88th percentile (goal:
85).
People—Fostering
employee pride and loyalty
The goal is to increase the Employee Partnership survey mean score
(goal: 73.6 percent, FY10 actual: 72.6), Physician Satisfaction survey
(goal: 74.3 percent, FY10 actual: 73.3) and encouraged continued
employee participation in spring 2011.
Quality—Providing
quality patient care in a safe environment
Smith outlined the hospital’s mortality percentile rankings (goal:
80th, FY10 actual: 70th) and feels with more effort, this can be
improved. He also spoke about needed improvements with hand hygiene
compliance (stretch goal: 90 percent). More details about this are
outlined later in this report.
Finance—Providing
the highest value to patients while ensuring financial stability
The organization continues to work in building its days cash on hand or
emergency fund (goal: 25 days, current 14.6). The hospital is on track
to meet the net income goal (goal: 25.5 million, current [through
September]: 7.4 M) .
Growth—Growing to
meet the needs of those we serve
At the time, outpatient volume in visits is down (goal: 5 percent,
current: -2.6). we believe it is due partly to a nationwide downward
trend in physician office visits because of the economy and patients
delaying hospital visits unless it’s absolutely necessary.
Employee,
physician, nurse awards
Smith recognized 16 MUHA employee of the month winners (May to
September); four physician of the month winners (May to August) and
five Nurse of the Month (DAISY) award winners.
Exceptional
performances
At the Studer Group’s 2010 What’s Right in Health Care Conference, MUSC
Heart & Vascular Center’s mortality ranking with Universal Health
System Consortium’s Mortality Index (fourth quarter, 2009) placed first
among 107 academic medical centers and second out of 108 facilities for
the past 12 months.
Also recognized was the Pediatric Emergency Department, which ranked in
the 97th percentile for patient satisfaction and winning the Service
Excellence Award. The group has surpassed its goal of reaching the 80th
percentile for nearly the past three years. The Peds ED started in the
60th percentile in 2007.
Patient survey
vendor transition
MUHA has used Press Ganey to measure patient satisfaction. Recently,
hospital leadership decided to change using Avatar International, a
tool that’s used to measure customer satisfaction in health care.
Since October, Avatar has been used to survey all MUSC patients, with
the exception of the Children’s Hospital and Peds ED areas, which will
remain with Press Ganey due to their specific patient population.
Leadership led the change based on customizable surveys based on the
patient services received and flexibility allowing the system to ask
patients about surgery, physical therapy, CT scans, ICU,
etc.—activities that can be used during a patient’s stay and
customizable questions and health education information based on
diagnosis and patient diseases, etc. Rating scale between Avatar and
Press Ganey also is different and more user friendly. Smith emphasized
that employees need to continue providing the best patient care and
service to all patients.
Hand hygiene
Since January, the medical center has moved forward in its ongoing hand
hygiene campaign to reduce the spread of infection.
The Centers for Disease Control and Prevention estimates that each year
there are more than 1.7 million health care-associated infections. And
those people who are infected develop it during the course of receiving
health care. Of the 1.7 million, about 99,000 will result in death for
that patient. As a result, potentially more than 90 people could die
from infections each year.
June Darby, Neurosciences Service Line manager, reminded all employees
to clean their hands using soap and water (15 seconds) or use hand
sanitizer. Employees should wash hands after using the restroom; before
and after eating; after sneezing or coughing; when entering or leaving
a patient’s room and putting on or disposing of gloves. Darby
recognized Digestive Disease Center/6East’s Rhonda Flynn, R.N., for
establishing hand hygiene best practices and education ideas with ART
employees.
Health care reform
In March, Congress passed the country’s Health Care Reform bill
designed to provide medical coverage to 32 million Americans who are
currently uninsured. Darby spoke about challenges that MUSC as both a
praovider and employer will experience on both state and national
levels.
On a statewide level, South Carolina is already experiencing budget
shortages for 2011 and 2012, which may mean there could be monetary
shortages in the budget to fully fund the state’s Medicaid program. It
is difficult to predict the overall outcome in this area.
Darby explained that in a worst case scenario, Medicaid payment could
decrease for FY 2011 by about $50 million. Nationally, Americans
continue to age, which includes the baby boom generation and increases
the number of Americans enrolled in Medicaid. Analysts predict that
Medicare will change the way it pays for care.
For example, Medicare is already withholding payments for care
associated with “never” events——hospital falls, hospital-acquired
infections, etc. Hospitals and physicians will continue to be
challenged to find new ways of caring for patients while reducing
costs. Other expected changes relate to adjusted payments based on how
a hospital’s performance measures.
To help prepare for change and potential payment reductions, hospital
leaders want to identify ways that the organization can reduce costs by
10 percent while preserving quality and safety (i.e. MUHA’s 5 & 5
Plans (5 percent reduction in costs each year for two years). This plan
focuses on reducing errors and avoidable events, creating efficient
workflows and improving efficiency while managing expenses.
Pharmacy and interventional radiology employees shared one idea to
reduce waste involving the clot-busting drug tPA, used mostly with
stroke patients. The team suggested that they cut the use down to 2mg
vials ($87) versus 50 mg vials ($1,961), which results in a savings of
$66,000 per year. Only 2-22 mg. is needed and the remainder is
discarded.
2011 Employee
Partnership Action Plan
Dave Neff, Ambulatory Cares service line administrator, reviewed the
top opportunities in the 2010 Employee Partnership Plan Survey.
Employees listed “My work group is asked for opinions before decisions
are made” (62.5 percent and up 2 percent since 2009) and “Leaders
really listen to employees” (57 percent and up 3.2 percent) showing the
largest increases to date.
Neff explained that leadership is developing a plan focusing on three
areas – communications, involvement and follow up. Neff stressed it is
important that every employee take responsibility to be well informed
and participate in identifying solutions in the challenges that lie
ahead.
Stop Light reports (green-completed; yellow-in process; red-not
happening at this time), which are used to color code the status of
activities, will continue to be the primary tracking and communications
mechanism.
Leaders will continue to use the town hall meetings as well as the MUHA
intranet, e-mails, and The Catalyst (Currents) as tools of
communications.
Involvement
innovation
Hospital leaders will continue to prepare a plan for increasing
employee involvement in problem solving and innovation.
Using the Stop Light method to provide updates and communicate follow
up; the green items indicates actions are completed; yellow, ideas
being investigated or under consideration for being implemented; red,
actions are not possible at this time.
To submit suggestions, contact Joan Herbert, organizational performance
director, 792-0726 or herbertj@musc.edu.
Looking ahead
During November and December, employees will be asked an additional
question to the set of core questions as asked by supervisors: What
ideas do you have for how we can reduce waste?
Employees are encouraged to share their ideas with their supervisor
during the next rounding session.
Connect to purpose
Neff referred to the “MUSC: Changing What’s Possible” communications
campaign and a patient family response after viewing the commercial,
“Independence: Epilepsy.”
Neff read a letter written by a patient’s mother. The mother, who has a
son with epilepsy, is a patient of Jonathan Edwards, M.D., director of
MUSC’s Epilepsy Program. The mother noticed that the commercial
featured the voiceover of Edwards.
“As I watch my son make progress and the seizures lessen in frequency
and severity, my heart fills with joy and hope for him…We couldn’t do
this without all of his devoted medical team. Thank you from the bottom
of my heart for bringing together such skilled and caring nurses and
doctors,” she wrote.
Final town hall
meeting
MUHA employees can attend the final meeting at 11 a.m. Nov. 12, 2
West Amphitheater.
Friday, Nov. 12, 2010
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