Currents March 19

To Medical Center Employees:

This month a series of town hall meetings have been conducted and attended by approximately 1,718 individuals to date. The final general session is scheduled for March 21 at noon in 2 West Amphitheater, and more departmental sessions will be conducted through March. A Tegrity recording of the town hall presentation will be posted on the medical center intranet next week.

Effective communication is particularly important during the challenging times we face. Everyone needs to understand our goals, the purpose for change, and the roles we play. In the future attendance at conveniently scheduled town hall meetings (including department-based town hall sessions) will be required of everyone employed by the medical center.
The March town hall sessions have focused upon the impact that Health Care Reform and other external influences have on our reimbursement for services. The current projection is an annual reduction of approximately $64.5 million by 2014. There are a number of initiatives under way to reduce costs while providing high quality care. The Huron Consulting group is assisting with some, but not all, of the cost reduction initiatives.

Targeted cost reductions recommended for Human Resources (premium pay and leave practices) amount to $5 million, and labor reductions amount to $15 million (total $20 million) out of a payroll of approximately $465 million. Huron uses a rational and disciplined process in assessing human resources practices and labor (staffing), aligned with the market trends and best practices.

My role as interim executive director, MUSC medical center, will soon come to an end and Dr. Pat Cawley will assume the position April 1. You have an outstanding new executive director.

I have enjoyed working with the clinical enterprise leadership team and others. I am confident the medical center is positioned to successfully address the challenges ahead and to fulfill goals of the clinical enterprise strategic plan.

Kester Freeman
Interim Vice President for Clinical Operations
and Executive Director, MUSC Medical Center

People–Fostering employee pride and loyalty
HR update
Helena Bastian, HR director, reported on the following:

• Compensation Policy Modifications (Key Elements)—HR Policy #15: Evening differential rates are in general authorized for an eligible hourly-paid employee who works at least four hours into the evening shift between 3-11 p.m. In addition to the four-hour minimum, employee also must meet one of the following requirements: Employee clocks in or after 10 a.m., or employee clocks out or after 11 p.m.; Night differential rates are in general authorized for an eligible hourly-paid employee who works at least four hours into the shift and four hours between the hours of 11 p.m. and 7 a.m.
• Press Ganey Associates Inc. acquired Morehead Associates in January, thus giving customers the largest trending database in the health care performance industry. Morehead will now operate under the Press Ganey name. All current usernames and passwords can be used at the Morehead website.
• Physician Survey will be April 28 through May 18. Employee Survey will begin May 19 and end June 1. Results from both surveys will be available June 30. Email floyj@musc.edu.
  

Wellness update
Susan Johnson, Ph.D., Office of Health Promotion director, shared complaints related to the smoke-free medical district. Surrounding businesses and private property owners complained about where MUSC employees are now smoking. She emphasized to managers to communicate these concerns with employees so that they are in compliance with the new city policies.

Other promotions include Fitness at Work/MUSC Moves activities with National Walking Day, Earth Day and other activities. Push-up & Up Challenge to support dropout prevention efforts and benefit Communities in Schools of the Charleston Area. The event will take place April 13 at Marion Square. Visit http://pushupandup.org.

Quality – Providing quality patient care in a safe environment
Lee Moody, Stryker Sustainability Solutions, whose company manufactures devices for MUSC's OR, electrophysiology and cath labs, shared results of sustainability efforts through reprocessing. In 2012, MUSC saved $1,067,648, diverting more than 8,020 pounds of medical waste from landfills. For these efforts, Moody presented MUSC the Stryker Healthy Hospital Award to Kelly Howard and Natalie Ankney.

Analytics department
Casey Liddy, chief analytics officer, shared MUHA's Office of Analytics and the work that his team does.
Liddy explained how his department works with groups such as OCIO, the Epic enterprise team and medical center staff in managing and interpreting data from the clinical data repository (OASIS) and Enterprise Data Warehouse and various data sources. The analytics group collaborates with teams from the Enterprise Data Warehouse and Enterprise Architecture and Enterprise Analytics and Enterprise BI to translate existing data collected from systems to create more useful information. Some best practices in these efforts include Cleveland Clinic and Duke Health. Current projects include OR projects with the OR working specialty group. Some accomplishments include meaningful use reporting, readmission rates reporting and service line market share dashboard views and other performance efforts. Recently, Enterprise Analytics supported a pediatric report from a U.S. News &World Report survey. Visit http://www.musc.edu/eir.

Epic update
Melissa Forinash, Epic program administrator, was joined by Christine Conzett and Andrea Coyle as presenters for the Epic program update. Forinash discussed the Epic Enterprise's latest accomplishments, implementation plans, reviewed milestones and upcoming readiness initiatives planned for the next 15 months. MUSC is currently at the mid-point of the Epic Enterprise implementation plan, with go-live scheduled for July 1, 2014.

Validation sessions, held last fall, were completed and were largely successful. In December and January, reengineering sessions were held to resolve system workflow validation questions still remaining following the fall meetings. Work for the integrated Ambulatory version upgrade is undergoing testing and will go-live on in June 1. The Emergency Department's ASAP lite module that launched Nov. 1 in 1W, CPC and Peds ED continues to be successful.

System building and training are the two longest phases for the implementation. Phase three activities includes system building, creation of oversight committees, planning for training and, end-user adoption and developing readiness teams.

Forinash shared other upcoming program milestones including the MUSC Health Link pilot and rollout will occur in early April, 2012 upgrades for ambulatory and ASAP will launch on June 1 and Kaleidoscope (Ophthalmology) module is set to go live July 8.

Conzett is the Revenue Cycle Operations director and updated managers about access and revenue cycle readiness (ARCR) program and its project leads. Efforts focus on establishing accountability with leads and workflow runs smoothly with project leads for both the revenue and access areas using adaptable workflows and intelligent system design. The leads also manage metrics and accountability to ensure success. ARCR leads are accountable for install decisions relating to their area, pre-live risk mitigation planning, developing new policies for best practices, review materials and other details.

Coyle, who is the professional excellence manager, also is the Partnership for Epic Preparedness (PEP) manager. She introduced the new PEP structure as an inpatient preparedness committee and project timeline. She spoke about how PEP will engage operational management from the go live and post go live period through formalized communications. The PEP process is structured similarly with the access and revenue cycle program and will involve PEP owners, members and owners of the implementation oversight committee to create adaptable workflows for efficiency. The Pep Project drop in/kick off is scheduled from 12:30 to 2:30 p.m., March 28, Room 125 Gazes, allowing hospital staff to meet people involved in this effort. PEP day will occur the day prior to the Epic Enterprise system rollout on July 1, 2014.

For information, visit http://epic.musc.edu.

Finance – Providing the highest value to patients while ensuring financial stability
Steve Hargett, chief financial officer, gave the hospital's financial results for the eighth-month period through February Fiscal Year (FY) 2013 and FY 2012.

The income report supports a positive bottom line with net assets of $8.9 million. This was due to a $7 million gain through the Guaranteed Investment Contract account termination from a December 2012 refinance of $300 million debt. A portion of this was used for the December refinance and $5 million was placed in escrow to be later used to pay down ART's Central Energy Plant debt later this year. The hospital is behind budget. This is due to multiple variables including lower patient volumes, less surgeries and procedures, and underpayment reimbursements in the state's managed-care Medicaid patients. The hospital plans to request additional reimbursement from the managed–care plans.

Investment income remains flat. Operating expenses, although up since 2012 due to Epic EMR program training costs are below budget at $5 million. Interest expense is below budget due to a substantial reduction in interest rate. Days cash on hand $22.8 million, eight days. Impact to cash reflects lower reimbursement (managed care), Epic training and new construction costs with a Central Energy Plant. As the hospital continues to make operational improvements and becomes more efficient, Hargett believes the outlook will continue to improve.

Friday, March 22, 2013