June Darby, R.N., Neurosciences Service Line administrator, explained the adult inpatient service goal for this fiscal year is for 78 percent of respondents to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to rate the medical center a 9 or 10 on the 10-point rating scale for the "overall hospital rating" question. To date, 80 percent of the survey respondents have rated a 9 or 10.

The outpatient service goal is measured by our Avatar patient satisfaction survey tool. The goal is for a mean score of 92.59 (current: 93.05).

People—Fostering employee pride and loyalty
The employee partnership survey concluded May 13 and only preliminary information is available. The goal is to achieve a mean score of 73.6 (currently 71.1). Darby indicated, while unfortunate, the drop by .5 from last year's results were not entirely surprising given the pressure many have experienced this year and is consistent with reports from other hospitals. More detailed information from survey vendor, Press Ganey, will be available by mid-June and results will be widely communicated.

Quality—Providing quality patient care in a safe environment
The hospital's percentile ranking slipped during October to January time frame and as of April, this year's ranking is in the 66th percentile. The goal is to achieve the 80th percentile among approximately 100 academic medical centers involved in mortality benchmarking. March results were particularly favorable (approximately 95th percentile for the month) and it's expected that the overall score will improve by year's end.

Compliance with hand hygiene audits is at 69.4 percent (stretch goal: 90 percent). Secret observers as well as inpatient and outpatient unit teams are observing this practice throughout hospitals and clinics.

Finance—Providing the highest value to patients while ensuring financial stability
The financial goal was to reach 25 days cash on hand and currently MUSC has 10.5 days. Another financial goal is to achieve a net income goal of $25.5 million (currently $21.6 million).

Growth—Growing to meet the needs of those we serve
The hospital's inpatient growth goal is 3 percent and to date, it stands at 1.7 percent. While MUHA observes a record-breaking census, acuity of care and length of stay has complicated reaching this goal. Inpatient growth goal is 5 percent, but currently it is at 1 percent. The hospital is feeling the national trend, as a result of the economy, of individuals delaying physician appointments and elective surgery.

Celebrating success
From July 2009 to June 2010, HCAHPS results between local hospitals showed MUSC ranking at 79 percent. From October 2010 to March 2011, MUSC was at 80 percent (HCAHPS national average hospital score is 67 percent).

The overall rating reports among a dozen similar academic medical centers rank MUSC in the 80th percentile or second highest in this category behind UNC-Chapel Hill, who was at the 81st percentile).

5 & 5 plans
The 5&5 cost savings initiative is intended to improve quality of care while reducing costs. The goal is to reduce costs by 5 percent this year and 5 percent next year. This campaign was necessary based upon Medicaid reductions at the state level and projected decreases in Medicaid and private insurance.

Looking ahead
Nancy Tassin, R.N., Musculoskeletal Service Line administrator, addressed employees about the effects of health care reform. Hospital leaders want employees to be aware of changes and will communicate these changes via upcoming town hall meetings.

Starting July 1, reimbursement funds at risk using CMS value-based purchasing (how much money will be at risk) is set at 2 percent.

Under value-based purchasing, 70 percent will be based on process core measures, while 30 percent looks at HCHAPS results (top 10 percent or higher).