Currents

To Medical Center Employees

At the Dec. 18 management communication meeting Dr. Danielle Scheurer, chief quality officer, and Sheila Scarbrough, patient safety manager, discussed "High Reliability Organizations (HROs)." It was explained that reliability is not just a strategy, but it is a mindset and lifestyle. Key concepts around HROs include: sensitivity to operations; preoccupation with failure; deference to expertise; resilience; and reluctance to simplify. Dr. Scheurer and Ms. Scarbrough reviewed feedback from a tabletop exercise conducted at the Dec. 5 Leadership Development Institute (LDI). Details on the communication meeting and LDI presentations can be found on the medical center intranet communication site at http://mcintranet.musc.edu/muscexcellence/communications/comm_mtgs/index_months_only.htm and the MUSC Excellence LDI site at http://mcintranet.musc.edu/muscexcellence/LDI/index.htm.

Dr. Scheurer explained the medical center has committed to a partnership with the South Carolina Hospital Association and the Joint Commission to promote adoption of high reliability practices in hospitals. The ultimate goal is significant improvement in patient safety and quality, resulting in a dramatic reduction in events causing preventable harm.

On another matter, as we approach the winter season everyone should be familiar with their department-based weather emergency plans and relevant Medical Center policies, including the Medical Center Weather Emergency Plan (policy A-64) and the Human Resources Hazardous Weather and Emergencies policy 13. Also, the management team should ensure everyone is aware of the Medical Center Employee General/Emergency Management Information line which serves to issue organization-wide and department-based instructions. The Emergency Management Information "card" is located at https://www.musc.edu/medcenter/emergencyManagement/source/MedicalCenterEmployees.pdf and can be printed.

Finally, as I wrap up my 40 year career at MUSC, I want to give my heartfelt thanks to everyone who has made MUSC a great place. I will greatly miss seeing my colleagues and friends on a day-to-day basis, but I will leave the organization knowing we have an outstanding team in place. MUSC is "changing what's possible" and it's because of all the dedicated staff, physicians and leaders throughout the organization.
Have a happy and safe holiday season.

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

People–Fostering employee pride and loyalty
Giving Back program
Chaplain Terry Wilson, Pastoral Care Services, shared results of a special grant program established in the medical center through the generosity of about 800 patients. Gifts totaling $49,382 were used to establish this fund earlier this fall. Criteria for the grant awards should support the mission of MUSC Excellence and quality patient care. A special committee was formed, headed by Wilson, whose task was to review 43 submitted applications and award grants totaling $24,542 to 15 recipients.

Award project include a variety of efforts from teaching materials and training to needed medical devices and project support. Next call for applications will be spring 2013 where the fund will award another $25,000 in grant projects.

Quality – Providing quality patient care in a safe environment
Danielle Scheurer, M.D., and Sheila Scarbrough, R.N., reviewed results from the Dec. 5 MUHA LDI's brainstorming session seeking feedback from participants on how MUSC can transition to become a high reliable organization. Scheurer described this effort's philosophy based on the book, "Managing the Unexpected," which explores this in a variety of industries. The book defines five foundations: Principles of Anticipation — sensitivity to operations; preoccupation with failure and a reluctance to over-simplify and Principles of Containment — resilience and deference to expertise.

Achieving this leads an organization from a state of mindfulness to high reliability and the ability to achieve high quality safe care.

Scarbrough reviewed LDI information which resulted in 463 ideas. These results were divided into five theme areas: sensitivity to operations; reluctance to simplify; preoccupation with failure, resilience and deference to expertise.
According to Scheurer, the next step is to partner between the SC Hospital Association and the Joint Commission to establish a statewide effort promoting the adoption of high reliability practices in hospitals. Tactics will be developed using information from this collaboration and from the idea gathering. Ultimately, the goal is achieve significant improvements in patient safety and quality resulting in a greater reduction in events causing preventable harm.

Online catering ordering system
Brad Masteller, and Gina Capps, both of Sodexo Dietetic Services, introduced the cafeteria's new online catering ordering system and menu. The new system will be launched in January. The system is user – friendly and requires customers to set up an account to place an order. All orders placed will be saved in each customer's account and a confirmation email will be sent. For information, email at cappsg@musc.edu.

Finance – Providing the highest value to patients while ensuring financial stability
Kelly Crowley, PharmD, manager for Ambulatory Pharmacy Services, reviewed new initiatives in her area including the new discharge delivery system and counseling process. This effort was initiated in the Children's Hospital in 2010 and started in ART earlier this summer. Discharge delivery will roll out to the university hospital in 2013. This process will improve patient outcomes because our pharmacy staff can verify doses from the inpatient system and calculate doses based on weight. The pharmacy also willwork to resolve compounding issues and prior authorizations. This prevents delays the patient may encounter if using off-campus pharmacies. Prescriptions will be delivered to the bedside and counseling by a pharmacist. The medical center's 340b drug program allows the pharmacy to purchase drugs at a reduced cost to help those in need. The program is only available to patients at discharge and in outpatient settings. Regarding retail pharmacy sales, pharmacy staff encourages patients to use MUSC retail pharmacies, which have yielded positive margin results (average margin is $80 per prescription). This new system was piloted at ART and resulted in a profit. The new delivery process helps patients get their medications quickly and brings dollars back to the hospital. A technician will work with unit staff to gather demographic and insurance information, review prescription information and work with pharmacy staff to coordinate details prior to delivery to the patient.

Announcement
The next meetings are Jan. 8 and 15.

Friday, Dec. 21, 2012