Friday, December 4, 2015

December Six Questions

Published in VC's Notes on December 04, 2015

Six Questions

Good morning!

I hope everyone had a great Thanksgiving holiday break.

I continue to receive lots of questions and comments in response to VC Notes.  I pass many of them on to administrators for further review and action when appropriate.  Here are six I will respond to today.

Q:  We are a state institution and as such, why are there political signs on UMMC property? UMMC should be neutral when it comes to politics and there should be NO signs of any politician or related to political issues on UMMC property EVER! 

A:  I certainly agree with you and for the most part our campus is free of the signs that favor one candidate or position versus another.  However, much of the property along the perimeter of campus is actually owned by the city or the state, and we don't have control over this public land. That's why, prior to the election last month, you may have seen political signs on the edges of UMMC property.  While we want to be respectful of the free speech rights of all and to encourage our employees and students to vote for the candidates and issues of their choosing, UMMC does not take sides or offer support in such matters and we do not condone political signs on UMMC property. 

Q:  I'm so glad you recently addressed the subject of flu vaccinations in terms as a best-response practice to protect the health of our patients. I applaud UMMC's 100% compliance goal, and am delighted that the university provides the quadrivalent (rather than the cheaper trivalent) vaccine.  I believe it's time for UMMC to next address another glaring public health issue created by medical leave policy of the state -- the requirement that all medical leave time be preceded by 8 hours of personal time. When faculty and staff workers are ill, this policy discourages them from taking proper leave. If "we have the obligation to work in the best interests of our patients and protect them from harm," then naturally, UMMC should make it a priority to retire this short-sighted, counter-productive -- and more than a little paternalistic -- medical leave policy.  

A:  I have received a number of questions and comments about the leave policy you mention.  Unfortunately, this is not UMMC's policy; it is written in the statutes of the state of Mississippi.  I do not know the rationale for this statute but I tend to agree with you that it can result in people coming in to work sick, which is not desirable in any setting and certainly not a health-care institution. Perhaps the best course is for you and others who feel this way to express your views to the state representatives from your district.

Q:  There have been many training sessions that were made mandatory for ALL employees even though they were geared at employees who work directly with patients. As a basic scientist, I am forced to take the "Error Prevention Training" course, for example, even though zero percent of the scenarios are relevant to basic scientists. We are forced to take the same vaccines even though we have no direct contact with patients. Is it possible that distinctions could be made in certain requirements for basic vs. clinical employees?

A:   As to the flu vaccine, even though our employees and students in non-clinical settings may not have day-to-day direct contact with patients, it is likely they have exposure to others on campus who have such contact, merely by riding the same shuttle, for example, or going to the cafeteria.  Regarding error prevention training, we began with the assumption that to make progress toward becoming a high reliability organization we would need to change our underlying culture.  Error prevention training is one step toward changing the culture of an organization by empowering all employees to engage with their colleagues, their managers and the processes that make the institution run.  When we brought this training from Arkansas Children's Hospital, we made the decision to include “everyone who wears a badge.” The reasoning was that we all have the opportunity to affect the safety of employees, students and patients.  A complete culture change cannot be expected if only a segment of the whole knows the expectations and priorities of the organization.  While the scenarios employed in the training may be more relevant to the clinical setting, topics such as teamwork, communication techniques, conflict resolution, and how to stop any process one feels is dangerous have wide applicability throughout UMMC.  Finally, as we move toward greater emphasis on interprofessional education, team science and collaboration across the health-care continuum, I believe it's important that we think of ourselves as one team, one family, “One UMMC.”  

Q:  Food question!!! Why no sushi? I am starving daily for something healthier in our cafeteria. Veggies are fine but when I am offered a veggie plate with macaroni as an option, that's not necessarily eating healthier. Also there is a lack of fish options daily. No doubt that "comfort foods" are essential to making people feel welcome in the hospital but I think adding more healthier fare in our cafeteria would send a stronger message about our commitment to eating right than endless taco salads or John Wayne casseroles.

A:  I've received a number of comments that echo your desire for healthier food options.  Our food and nutritional service leaders tell me they offered sushi a few years ago through an outside vendor.  Even though no raw seafood products were included, the Health Department was not comfortable with keeping these products on the menu. They plan to revisit the sushi question in the future.  Some healthy fish options like baked tilapia and cod are offered on a regular basis, but are not as popular with customers as other “comfort foods” you mention.  Having macaroni and cheese as an option on the veggie plate seems to be customary in the South and indeed mac and cheese is reported to be the best-selling “vegetable.”  But our food service staff is always on the lookout for other veggie options and say they will offer an updated vegetable lineup later this month.  The made-to-order taco salad can be customized to make it a healthier option by adding grilled chicken instead of beef or by skipping the meat altogether and going vegetarian.  Chick-fil-A offers char-grilled selections that are relatively healthy choices, and grab-and-go items like hummus, fruit and yogurt are readily available.  Finally, our food service folks are working on a new labeling system to help their customers better identify healthy choices. They say the system should roll out toward the end of the first quarter of 2016.

Q:  As a medical student training here, we are exposed to a number of services and many aspects of patient care. I have worked in the ICU setting and have been involved in surgeries in which the patients are taken to the ICU from the OR or the ED through a public elevator and family waiting area. Often these patients are on ventilators, have significant wounds or are requiring other medical intervention during transport. On two or more occasions hospital staff has brought up the idea that this is not the most patient-centered practice nor is it an appropriate area to transport. It seems to me that some of this comes with the realities of being in a hospital, but at the same time, a number of bystanders may end up seeing someone who, if they could help it, would not appreciate being seen in this vulnerable state. This poses some privacy issues as well as concerns for children and others who aren't prepared to see these often harsh realities. This is a minor issue, but one that I think could be improved upon and may result in better perception of our hospital.

A:  If we could redesign our hospital from scratch, I expect we would start by developing separate elevators and hallways for non-ambulatory patients such as those you describe.  Since that's not a realistic option, it's up to us as caregivers to always be mindful of our patients' need for privacy and dignity.  In some cases, that may mean waiting for the next elevator when a patient is being transported from the OR to the ICU.  Or it could mean that we hit the “pause” button on our conversation about our weekend plans while we're in the presence of a patient in a highly vulnerable state.  Although it may seem like a minor issue, these little ways we show our concern for the welfare of our patients and their families make a big difference in their experience here.

Q:  Dr. Woodward, I'm very excited about the different changes that are being made around the campus, but once all of the changes are completed, will there be any chance that the employees that had parking on campus will be able to return in the future?

A:  When Parking Garage C opens next summer it will offer 915 new spaces for on-campus parking.  Of course, those garage spaces will carry a higher fee than on-campus surface parking and the free parking at the stadium.  When those spaces come online, we will allocate them according to the protocol established in the parking policy.  With the completion of the new research and medical school buildings, we do expect to gain some additional surface parking that was previously displaced, but nowhere near what we had before, and our future growth will continue to claim on-campus parking spaces.  In addition, we will always be sensitive to the need to park our patients and their family members close to the facility.   For our personnel who continue to park at the stadium, the good news is that parking will continue to be at no charge and, with the opening of the third garage, it should be easier to find a parking spot closer to the Medical Center.

Thank you for all of your responses to VC Notes.  I have received many encouraging comments about how this weekly communication has enhanced your understanding of what's going on at the Medical Center, and that was exactly my intention in starting this column last March.  The more we can be united in reaching our goals, the sooner we'll get to A Healthier Mississippi.

 



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