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Town hall meeting focuses on preparation, feedback

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

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

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.