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Missing Blood Glucoses?

When patient's blood sugars are checked in the hospital, the machine has to be physically "docked" at a docking station before the results will appear in the medical record (e.g. Oacis). Our organization goal is to have all meter "docked" within 30 minutes of checking a patient's blood sugar, so that all providers can see and respond appropriately to the results. At the current time, the FDA has not approved a glucometer for use in hospitals that wirelessly transmits results to the electronic medical record (EMR). 

 

It is important that all medical staff understand if a blood glucose is missing in the EMR, it is possible that the glucometer has not yet been docked. Check with the patient's nurse if the result is missing.

 

There is a unit-based "dock time report" available here

 that shows dock time by nursing unit, to enhance awareness and improve the results of dock times. 
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Documentation Corner:

Lacerations/Punctures during Surgery or Procedures

Physician documentation in the medical record is used to develop quality and safety reports that are mandated by hospital regulatory agencies. It is essential that the documentation be as specific as possible for these reports to be accurate. Coders are not allowed to infer anything from the physician documentation. 

 

What Should Physicians Do?

If a puncture, tear, capsular laceration, enterotomy, colostomy, serosal laceration or "injury" occurs due to patient-specific factors (e.g., the nature of the adhesions, the tumor, or other conditions present during the operation) that you believe are routinely expected and inherent to the procedure performed, documentation must clearly state that the event was inherent to the surgical procedure to avoid the incorrect reporting of a complication.
 

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June 27, 2013
Welcome New Medical Staff

Dear MUSC Medical Staff,Dr. Cawley

 

Over the next two weeks at MUSC, we will welcome 236 new residents and fellows and over 90 new attendings to the medical center medical staff.

 

Historically, much has been written about the academic medical center "July Effect". Urban legend states that patients are harmed because of this "July Effect", but the most current evidence does not support this.

 

However, one can't simply ignore the high number of new medical staff and employees this time of year. Even the number of hospital employees is a little higher this time of year. Bottom line, there are a lot of new people taking care of patients in the MUSC system.

 

These new team members do not yet know the MUSC system. They also do not know each other yet and, therefore, will not optimally function as teams. Although they receive plenty of orientation, it will take weeks, even months, to fully understand the system. Furthermore, many of the medical staff, especially the residents and fellows, are graduating to a new level of responsibility. This type of accountability change can challenge even the most confident of physicians. I can easily recount for you my first night on call as an intern, as a second-year resident, and even as an attending. I also remember the first time I was an attending in a new hospital.

 

What can you do?

  1. Introduce Yourself - Go out of your way to introduce yourself to not only medical staff by all hospital staff. Let's spread that Charleston charm!  
  2.  Explain - Hospitals are complex adaptive systems. It takes months to understand a new medical center. Take the time to explain the MUSC system. Also be sure to explain why we use certain methods.  
  3.  Critical Awareness - Remember that there are many new team members this time of year. Pay even more attention to the details of what is occurring around you. Speak up if you recognize a problem.  
  4. Patience - Things are simply not going to work as smoothly this time of year. Take a deep breath and remember that you were once new as well! 

Thank you for the great care you provide every day!

 

Sincerely,

 

Patrick J. Cawley, MD
Executive Director/CEO, Medical Center
Vice President for Clinical Operations, University

Our Vision (A picture of how we will look in the future)

MUSC will be nationally recognized as a premier academic medical center

 

We will change what's possible by relentlessly transforming expertise, learning and discovery into unrivaled care. As the State's leader in advanced care, we will improve the health of South Carolinians. Interdisciplinary teamwork, coordination and accountability across our unified clinical enterprise will generate the performance and resources that fuel the rising trajectory of our reputation. 

MUSC Health Strategic Plan

 

Things You Should Know about

the Admit Transfer Center (ATC)

  1. All patient placement is managed by RN's.
  2. ATC RN's have a variety of clinical experience: Pediatrics, Cardiology, ICU, Rehab, Surgery, Medicine.
  3. All patient placement MUST go through the ATC (excluding IOP admissions).
  4. The Admission Request Form is located on the intranet.
  5. All calls from outside physicians requesting admissions are managed by the ATC.
  6. The ATC RN stays on the line during the call with MUSC and outside physician to facilitate admission.
  7. ATC is always open.
  8. We are located on the first floor Main Hospital behind registration.
  9. ATC is actively involved in the Disaster Preparedness process.
  10. All calls to the ATC are recorded for quality improvement purposes.

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