Thoughtfully Committed

Good morning.

Before I get to what I plan to speak on today, I’m happy to report that - while there are still a small number of verifications and requests to finalize – we’ve gone over 99% compliance among employees with our vaccination policy. That’s fantastic! Thank you for putting patient safety first and for being a health care leader in Mississippi.

Several times in this column, I’ve referenced Leadership Rounds, which is a monthly get together of many leaders from across the Medical Center hosted by the Office of the Chief Medical Officer where groups of three visit designated clinical areas and talk to staff about certain topics. It’s a great opportunity for Medical Center leaders, including from non-clinical units, to visit areas they don’t normally go, learn more about topics they don’t normally deal with and for managers and staff of clinical units to speak on topics that are affecting them.

This past Tuesday was a Leadership Rounds morning, and I want to say a thank you to all of those who routinely gather and participate in this exercise. I know some of the leaders invited have schedule conflicts and are not able to participate every month, but I am very grateful to those who make it a priority to attend and take part. Our theme this week was centered on care coordination.

The opening presentation prior to rounding was done by Penny Gilbert, our new chief of coordinated care, and Dr. Lisa Didion, who serves many roles, one of which is medical director for coordinated care. They and their team are embarking on vital work intended to positively impact all areas related to care coordination – which is a big part of Strategy 1 of our new strategic plan: Maximize Value in Quality of Care. Lots of work is going on in this area – with plans to expand to more units – that I will share in more detail at a later date, but today I want to speak on a topic that came up during rounding and discussed in the debrief meeting

Dr. Patrick Smith, chief faculty affairs officer, Dr. Alan Jones, associate vice chancellor for clinical affairs, and I rounded together and heard the same question from several of our nurses. Though worded a bit differently by different askers, the question was, “What are we going to do at the end of the month when the MEMA (Mississippi Emergency Management Agency) contracted nurses leave?” I want to share some thoughts with you on this topic. (Twenty Department of Defense clinical staff deployed at UMMC will be leaving on Oct. 21 and 91 staff designated to UMMC by MEMA will all be gone by Oct. 31.)

The crux of the matter boils down to the challenges we are facing with staffing in multiple job roles – RNs, CMAs, RTs, CNAs, techs, LPNs and many others. This is a complicated situation that is affecting health systems nationally.

From the big picture standpoint, I want you to know that I and a dedicated group of leaders are working diligently on a larger multifaceted plan that I believe will put us in a different and better place with regards to clinical staffing. Stay tuned – more on this coming soon. 

But to more specifically speak to the immediate question, the outside resources (contracted nurses, RTs and physicians) that have been made available – including by covering the costs – as part of the statewide pandemic response have been very helpful. There have been some challenges associated with bringing in and quickly utilizing this deployment of new staff, but on balance, they have allowed us to open new beds, keep existing beds open and have made it possible for us to augment our own staffing. Those contracts are winding down at the end of this month and these additional staff will be leaving our units. 

When that occurs, we will assess our available staff, and we will make decisions about the number of beds and units we can operate with available staff according to our usual nursing standards and patient ratios.

We are now, and have been for a long time, working hard to hire staff, but we know we are still short of what we need. Evidence of that is seen in the perioperative areas, operating rooms and procedural areas, like GI and interventional radiology, where currently we have decreased available hours due to staffing shortages. I don’t like reducing operating room or procedural area hours, and I do not want to close beds. I feel confident in speaking for the entire UMMC leadership team on this issue. We understand the acuity level of our patients and the tireless work our clinical teams do to provide for our patients. As caregivers, we are called to “first, do no harm” and, like you, our leadership team is committed to patient safety and high-quality care.

This commitment starts with positioning our staff to provide safe care, which means we must maintain our current standards of nurse-to-patient ratios barring unforeseen or unpredictable events such as weather emergencies, unexpected call-ins, etc. The clinical leadership team – Dr. Jones, Britt Crewse, adult hospitals CEO; Guy Giesecke, Children’s of Mississippi CEO; Jason Zimmerman, interim chief nursing officer; Dr. George Russell, CEO of University Physicians; and Dr. Chris Anderson, chair of the Department of Surgery – are prepared to reduce available beds, if needed, in order to do that.

Yes, we are facing challenges, greatly impacted by our response to the pandemic, and we certainly aren’t unique in our need for additional clinical staff, which is a pervasive problem in hospitals across the country. Despite these struggles, we are committed to continue doing all we can to foster an environment where we  provide the type of care and experience our patients expect from us.

We’ve set a high bar, which is certainly a good thing. We may need to make hard decisions in the coming weeks, but we do so with quality and safety as our guiding star (remember quality is our number one institutional priority).

While we cannot predict the timing, I am confident that we will work through these staffing challenges. We are so proud of the work done by the UMMC family in the last most challenging two years. I am very grateful for the commitment, heart and dedicated spirit you have all brought to bear. Thank you for making it possible to continue to move forward to our vision of A Healthier Mississippi.