Brian Sloan, digestive disease service line administrator, and June Darby, R.N., neurosciences service line administrator, shared information at the medical center's quarterly town hall event.
Connect to Purpose
Sloan read a letter from a North Carolina family who received services in 8E. The family praised staff for their teamwork in providing excellent patient care for their daughter who is diagnosed with cystic fibrosis.
"Sometimes in this data-driven, high-tech world of hospital care, it's easy to forget the impact of meaningful human interactions and how central they are to a patient's recovery. Our family is grateful to your hospital and to 8E for providing such high quality patient care to our daughter."
Joint Commission Visit
October's visit by the Joint Commission resulted in a positive survey with 20 total findings (nine findings requiring action plans in 45 days and 11 findings requiring action plans in 60 days). The Joint Commission team was very complimentary of staff professionalism, knowledge and attitudes. These findings represent about half of what's expected for a hospital of this size and a third of what the Joint Commission found from their last visit in 2009.
Multiple medical center awards for performance from various national organizations since last quarter were acknowledged. Most notable is MUSC's 2012 Rising Star Award from the University Health System Consortium (UHC).
The award is based on several metrics including mortality, effectiveness, safety and efficiency of care. MUSC achieved a 20-place increase among 101 member institutions landing in the top 20. MUSC was previously recognized with this award by the UHC in 2008.
MUSC leads the state ranking as the No. 1 hospital in South Carolina by U.S. News & World Report with six nationally-ranked specialties and nine high performers. MUSC surpasses Greenville (No. 2) and Spartanburg (No. 3) in these rankings.
MUHA Executive Director Search
Progress continues in the search to find a replacement for Medical University Hospital Authority Executive Director Stuart Smith. Smith has agreed to stay on in his role until his replacement starts in early 2013.
HIPAA Privacy and Security
- Regular audits are conducted on samples of electronic medical records. The audits include all employees who are patients and high-profile patients. Unauthorized access of these records is a violation of HIPAA privacy and will result in termination.
- There have also been issues related to proper use of social media (Facebook, Twitter, etc.). Employees should never discuss patient information in these formats, and violation to this policy will result in terminations or suspensions.
- Caution should also be applied with phishing emails. Employees were reminded to safeguard their email passwords. OCIO will never send an email asking for employees to disclose password information. Never open an email suspected of phishing.
2012 Employee Survey
This year's survey yielded an 80 percent participation rate. The medical center's overall commitment score was 4.06 on a 5-point scale (36th percentile). The national average (Morehead Associates' database) is 4.16. The 2013 goal is to reach a commitment score of 4.11. This score will still be below the national average but was recommended by Morehead Associates, the survey vendor, as a realistic, statistically significant increase to work toward in a single year. Currently there are 422 work group action plans that have been developed and implemented to help reach this goal.
Employees have experienced challenges this year ranging from no performance increases in October, reductions in overtime, floating work assignments to reduced hours. There have been multiple outside influences impacting activities in the medical center. The nation's economy is struggling with about 8 percent unemployment since 2008. There are currently more than 40 million people who are uninsured. At the same time the cost of health care is growing faster than any other segment and will soon be 20 percent of the gross domestic product. But we continue to have health outcomes lower than other countries.
These external pressures are having multiple impacts at MUSC. Inpatient, outpatient and operating room (OR) case combined volume remained flat throughout 2012. OR cases are down due to the departure of several surgeons. SC Medicaid reimbursement was cut by 7 percent ($20 million) this past year. In the next seven years, Medicare will cut $190 million from payments and disproportionate share funds will be reduced by $66 million. With Medicare and Medicaid cuts MUSC can expect a cut of $56 million per year or $256 million total in seven years (2014 to 2020). In addition, Blue Cross and Blue Shield affirms that there will be no rate increases. Remaining Medicare reimbursements will also be linked to value-based purchasing (CMS) metrics based on the hospital's compliance with quality treatment processes and H-CAPHS (Hospital-Consumer Assessment of Healthcare Providers and Systems) scores. If score levels are low, payment levels will decrease, but if scores are high by national comparison, reimbursement may be higher.
To prepare for these changes, the medical center, MUSC Physicians and the College of Medicine have established the MUSC Health Strategic Plan to direct activities.
Faculty recruitment is focused on specific specialties including neurosurgery, ophthalmology and hand surgery to help impact new growth. The revenue cycle will combine hospital and physician patient accounting functions in preparation for the medical center's conversion to the Epic electronic medical record system (July 2014). Updates are being done to streamline supply costs for further efficiency. The hospital's 5-and-5 accountability plans will continue to be implemented throughout the organization. Matching staffing to workload and defining initiatives for quality improvements are additional ongoing efforts.
It was noted that these challenges are not just occurring at MUSC but are front burning issues for hospitals and medical centers across the country.