Friday, October 30, 2015

Five Questions Oct

Published in VC's Notes on October 30, 2015

Five Questions

Good morning!

Today I'll answer some of your recent questions.  Before I do that, I want to congratulate Dr. Jeffrey Vitter on being named the next chancellor of the University of Mississippi yesterday in Oxford.   He looks to be an excellent choice, and I want to extend my thanks to Drs. Claude Brunson, Ralph Didlake and Charles O'Mara for serving on the campus search advisory committee. 

Thanks also to those of you who were able to meet Jeff and his wife, Sharon, on their visit to UMMC Wednesday. I was impressed with his vision for UM and his sense that the Medical Center is a vital and valued part of the University. I look forward to a long and productive working relationship with the new chancellor.  

Now, on to your questions.  Remember that I read all of your questions and share many of them with leaders for further review and action.  I'm only able to answer a few in this column but they are often ones that have been asked by more than one person.  I appreciate ALL of your comments and questions.

Q:  My comment is regarding the new hand washing policy the center is promoting. In many clinics - Eli Manning and Grant's Ferry are what I know firsthand - handwashing foam is not readily available upon entering the room. In fact, the canister holders are often in the back of the room behind patients, family members or other members of the team. This is remarkably different from the hospital, where foam is not only in the hall next to rooms' doors but also just inside the door, thus making the habit relatively easy to form. So I would think that the best way to achieve your goal compliance would be to make handwashing as convenient, integrated and thoughtless as possible, which would entail better placement of foam canisters in clinics. Would this be possible?

A:  This is a great example of a “barrier” to good hand hygiene recognized and brought to our attention by an engaged frontline!  These are exactly the reactions we are looking for so that our Hand Hygiene Team can help remove such barriers. I passed your comment along and I'm happy to report that the foam dispensers are being relocated in the Eli Manning clinics and new dispensers are being ordered for Grant's Ferry.  Our team is also planning a system-wide assessment on availability of foam and soap dispensers to be sure it is as easy as possible for everyone to comply.  Thank you for this suggestion, and for all our other readers, please let us know if you see other barriers to hand hygiene.

Q:  As advanced as technology is today, has there been any thought about having an app for the shuttle buses? A scenario: It's 1:00 and you have to leave to get your child to a doctor's appointment at 2:00. It would be nice to be able to look at the app to see if a bus is coming, and if not, you could just start walking to your car in overflow. I realize in the grand scheme of priorities at the Medical Center, this is not a top one, but I believe it would improve staff satisfaction.

A:  The timing of your question is perfect because, beginning Monday, the institution will welcome a new partner - Groome Transportation - that will provide a fleet of brand-new 56-passenger buses, each fully equipped with GPS capabilities. The new shuttles will have many attractive features, including front- and rear-facing onboard cameras, electronic displays that will indicate which route each shuttle will take, and exterior “wraps” that will highlight the many services UMMC offers to the community. Every seat has a seatbelt, every vehicle is outfitted with Department of Transportation-prescribed safety equipment and the fleet is fully compliant with American Disability Act standards.  But perhaps the most welcome feature is the GPS capability, which is expected to become available by the end of November. To read more about the new fleet, click here.

Q: What is going to be done about the cleanliness of the hospital? It's embarrassing for visitors to see the filth of the public restrooms and some of the elevators. Sometimes trash isn't picked up for 2 days, spilling onto the floor; paper towels and hand foam dispensers aren't replenished when empty, etc. This is a concern for the spread of infection.

A:  The cleanliness of the hospital has been of concern for some time.  For that reason, several months ago we made the decision to change our housekeeping vendor.  This is a lengthy process that requires approval by our board.  The new vendor, Crothall Healthcare, will begin work under the new contract this Sunday, Nov. 1.  We have heard good reports from other academic medical centers and teaching hospitals where Crothall provides housekeeping services.  I think you will notice a difference immediately.  However, I ask for your patience and support as we make this transition.  Remember that at some level we are all responsible for the appearance of the Medical Center.  

Q:  I know protecting employees and staff is very important at UMMC, but why must it be mandatory for employees to receive the flu shot? I am not against vaccinations, but I am against having to inject toxins into my body that are not even proven to protect against getting the flu. Other states are making it illegal for employers to make such vaccinations mandatory. I realize as an academic medical center, UMMC receives extra compensation from the state and federal government for 100% compliance on flu vaccinations, but is money more important than the rights of your fellow employees? I just believe that forcing us to get a vaccination that isn't even proven to work is a bit ridiculous….It actually upsets me that it is marketed as a way to "protect" ourselves and patients, when in reality it is just for financial compensation. I would like to hear what you have to say on this topic.

A:  I checked with the head of our infectious disease service, Dr. Skip Nolan, on two points you raised.  First, UMMC receives no additional reimbursement for requiring all personnel to be vaccinated.  And second, we are not aware of any states that have made it illegal for health-care employers to mandate vaccination.  Vaccinating our staff and students against the flu is, above all, a patient safety issue. Although protection offered by the vaccine is imperfect and subject to variability from year to year, its overall ability to prevent flu in healthy adults is around 70 percent. Everyone gets the flu, at least once every three to four years.  No matter how careful or hardy you may be, you still get it. At issue is the fact that in healthy adults it may manifest as a cold. Most health-care employees who have colds decide to come to work anyway. They then may transmit the flu to our immunocompromised patients in whom it may well be fatal. We have the obligation to work in the best interests of our patients and protect them from harm. Despite urban legends and what you may read on the Internet, the vaccine has an excellent safety record, having been given to millions of people for more than 30 years.  

Q:  I have noticed for a short while now that our state flag has not been flown under the U.S flag on the flagpole out front. Why is that? UMMC is a Mississippi state government-run hospital and college, right? If so, where is our flag? As a born and raised Mississippian, I take great pride in seeing my state's flag being flown.

A:  After discussions with senior leaders over several weeks, we removed the state flag from in front of University Hospital during the Labor Day weekend.  We did not announce this decision at the time because we did not wish to add to the divisiveness that already surrounds this issue.  At the heart of the issue for us is that as health-care providers, our mission of service is founded on respect for the dignity of all.  Flying a flag outside our “front door” that may be perceived as unwelcoming is in conflict with that commitment.  We love our state, we respect and support our state's leaders, and we want us all to move forward together.

Thank you for all your questions and comments.  They are helping me stay in touch with what you are thinking and feeling.  And now it's time to get on with the work of building A Healthier Mississippi.



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