To Medical Center Employees:

At the Aug. 21 Communications meeting, Dr. Peter Zwerner, chief medical officer, MUSC Physicians, and MUSC Health Strategic Plan strategy leader, updated the management team on the MUSC Access Initiative. One of the most critical components of the strategic plan is patient access. This is a broad-based initiative and, as Dr. Zwerner explained, will involve re-engineering MUSC's access process.

The Access task force has examined best practices at other leading academic medical centers. Among other things, best practices include a standardized access policy, a centralized access function and a master scheduling template. Dr. Zwerner summarized his comments by explaining the net result of the access initiative will be an enhanced patient experience, improved MUSC brand reputation, less complaints from prospective patients and better financial performance. Additional details are included in this newsletter.

In a recent Currents newsletter I explained that we need to reduce the medical center's labor costs for fiscal year 2013. A number of cost reduction tactics are being investigated at this time. For instance, all directors have been asked to reduce labor costs to the 25th percentile for their respective University Healthsystem Consortium (UHC) peer group, as measured by the Action O-I benchmarking system. In order to fill a vacancy, the respective department director and administrator will need to demonstrate staffing is at the 25th percentile for the respective peer group or provide other relevant data to justify.

Also, in relation to other cost reduction tactics, we will need to examine premium pay and other factors that contribute to labor costs. At the Aug. 21 management communication meeting it was announced that plans are under way to discontinue accruing of Supplemental Medical Leave (SML), with a projected cost savings of $1.5 million. No one will lose any leave currently accrued and may use it as in the past, but the SML program, as we know it (which involves transfer of Extended Sick Leave to SML), will be discontinued in the new calendar year.

On another matter, we are now in the midst of hurricane season and the management team needs to ensure everyone understands their department-based weather emergency plans and relevant policies. Everyone also needs to be familiar with the Weather Emergency Card, which is posted on the intranet at https://www.musc.edu/medcenter/emergencyManagement/source/MedicalCenterEmployees.pdf.

Finally, City of Charleston leaders contacted MUSC and asked that we work with them to house the City's incident command in Ashley River Tower (ART) during periods of potential power outages, such as storms or other incidents affecting power. Key medical center staff worked with City police and fire department leaders to make arrangements to accommodate their incident command in ART. We are pleased to have this cooperative working relationship. The City expects to have its own new facility to house their incident command in 2014. In the meantime, we will welcome their presence in the event of a weather emergency or other incident affecting power.

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

People – Fostering employee pride and loyalty

HR update
Helena Bastian, MUHA HR director, presented the following:

• SuccessFactors —Employee reviews are due Aug. 31 and should be electronically signed by the supervisor and the employee by that date; organization goal results have been loaded into SuccessFactors; and questions or concerns may be directed to Kim Duncan, duncanki@musc.edu or Forman, foremanm@musc.edu
  
• Pay Increase — Effective Aug. 26, eligible employees will receive a 1/2 (.5) percent; eligible employees are those who occupy a regular, permanent position. This is a one-time increase and is not related to an employee's performance rating(s). Increase(s) will be reflective in the Sept. 19 paycheck
  
• SML Provision — Effective Jan. 1, the supplemental medical leave (SML) provision in HR Policy#18, PTO policy will be phased out; transfer of ESL hours to SML bank will be discontinued; employees with SML balances may continue to utilize SML hours until balance is exhausted.
  
• Upcoming training — Presentation Skills Workshop (1 – 2 p.m., Sept. 12, Room 207, QE. The course covers simple ideas and tricks on presentation, design and delivery; HICS training (10 – 11 a.m., Sept. 18, Room 2408 Ashley River Tower); Basic introductory session to the Hospital Incident Command System that is used for disasters. Register via CATTS or email Allen Coulter, coulteal@musc.edu.

LDI Tracking Database update
Mary Fischer, R.N., senior clinical analyst in Enterprise Business Intelligence, reviewed details about the database that was created to track MUSC Excellence initiatives, thank you notes and rounding.

All administrators, managers, directors, supervisors and designees have rights to enter this database to enter MUSC Excellence activities and manage staff qualifications. With the medical center's push toward Magnet designation, nursing management has asked that staff education also be tracked.

Fischer reviewed the system's data entry screens. Under staff qualifications (licensure and certifications), anyone can enter information in this area. The hospital needs to report the percentage of all nurses have certifications. Several reports can be accessed from this screen. Competencies, CATTS and immunizations also can be accessed. The education form has been updated including credentials, education (highest nursing degree and other degrees). Other details need for Magnet tracking are current school, name of school, degrees working and start date, organizations and professional recognitions. Managements can track staff rounding via an administrator manager report, supervisor reports (arbitrary database), etc.

OCIO offers training (second Thursday of the month from 1– 2:30 p.m., Room 220, Clinical Sciences Building), to learn about this database. Register via CATTS.

Quality – Providing quality patient care in a safe environment

Dan Furlong, OCIO working in the Project Management Office, reminded managers of the submission status for projects within MUHA's project request system. Once an OCIO project request (see forms toolbox on the intranet) has been submitted, it is evaluated and ranked by priority. The committee uses various criteria which include Institutes of Medicine quality measures, financial impact, risk for the organization, etc. So far, more than 550 projects have been completed with some 100 projects still active. Currently, requesters are being contacted regarding the status of active projects. With the Epic enterprise project kickoff scheduled for Nov. 1, some projects will need to be validated and prioritized due to priority with Epic. Projects may be cancelled or placed on hold until after Epic's installation. Any work required for the McKesson system will be completed by McKesson as part of a limited outsourcing agreement.

Service – Serving the public with compassion, respect and excellence
Peter L. Zwerner, M.D., chief medical officer, MUSC Physicians, addressed managers with an overview of the medical center's new Access Initiative. He reviewed the current state of access, addresses best practices, outlines a goal for access and the implementation.

Zwerner pointed out weaknesses in the current system in handling new and existing patients. He reviewed the current system which uses a team of schedulers, registration staff, nurses, providers and administrative assistants who field more than 100,000 calls per month where more than half of the calls are non-scheduling relating. As of 2012, a little more than half of all online appointments were scheduled. Also lag days for new patients fell behind by more than 30-plus days in four sub-specialty medical areas. The current system, according to Zwerner, clearly challenged a patient's access to services and care at MUSC.

To create a new patient-centric plan, hospital leaders looked at best practices of the top 20 nationally-ranked hospitals and identified their successes with access as using a standardized access policy, centralized access function and use of a master scheduling template. Hospitalwide, leaders identified access imperatives — aggressive competitors, market share, lack of new patient growth, employee and patient satisfaction and cultural shift in patient expectations.

The plan, which is modeled after Emory Clinic's access efforts, utilizes tenants with supply and demand/re-engineering, increase new patients, standardize metrics and develop and master scheduling system.
More specifically, the medical center will focus on scheduling new patients within seven days; standardizing and reducing appointment types; establishing a formal process when an appointment cannot be made and developing protocols for late, pre-scheduling and new patients after hours. Phase 1 of the plan will be incorporated at MUSC Health East Cooper, which will utilize Swat work teams involving staff, department administrators and clinical faculty to expand access at the facility and build work dashboards. Teams will serve as key operation pieces evaluating metrics, communications, central scheduling and systems and practice re-engineering.

Each department, division and team will work with a d physician champion and business manager/administrator will partner with work teams to develop access strategy for their department/division in this process. All department access plans will be approved by the Executive Access Committee and Clinical Leadership Council. According to Zwerner, the project kicked off June 29 with executive access work teams and physician champions being established and leadership currently developing baseline metrics, reports and presentations due by September.

Announcements

• Phyllis (PJ) Floyd, R.N., is the new manager of Clinical Documentation Integrity and Data Abstraction in Patient Access Services. Floyd worked 20-plus years in leadership and management experience in the clinical arena. She recently worked in home health and the acute care setting in the director and manager positions.
  
• Action O-I data reports for the quarter ending June 30 are due by Aug. 29. For information, call 792-8793.
  
• The next Communications meeting is Sept. 4.