It is our goal to provide you with the information that you and your family need to feel comfortable as partners and decision-makers in your health care, whether you are with us for outpatient services or inpatient care. We call that approach "Patient and Family Centered Care." In addition to the many resources provided at the Medical Center and on the MUSC Health website, we are providing data and information on a range of issues in three categories:
And we want to be completely transparent. You can review the data here and determine how it affects you. Since scientific data can be difficult to interpret, we have provided additional explanations where necessary.
Because we care about your safety, we have set the bar very high for ourselves. We are never satisfied, even when we are among the best in the country. MUSC uses a continuous improvement process based on Six Sigma and Lean manufacturing principles called IMPROVE. The acronym stands for
A team of physicians, nurses and other support staff work together to determine the root cause of problems, find solutions and monitor performance to be sure the proposed solutions are working.
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The goal of MUSC Quality & Safety is to provide evidence-based care with zero harm for every patient, every day. Here are a number of quality and safety measures we use to gauge how well we are performing.
Hand washing can prevent the spread of disease. This measure is the percent of times health care providers and workers wash their hands before and after contact with a patient.
Urinary tract infections are fairly common among patients who have Foley catheters. This number is the number of infections that occur per catheter days among patients with catheters.
Surgical incisions expose the body to possible infection. This number is the number of infections that occur as the result of a surgical procedure.
Patient Safety Indicators are a set of indicators providing information on potential in-hospital complications and adverse events following surgeries, procedures and childbirth.
This index is the ratio of patients who died compared with the number of patients that were expected to die from their serious illness or injury.
Core measures are a set of metrics required by the Centers for Medicare and Medicare Services to monitor patient safety.
Readmissions is defined as the percent of patients who have to come back to or even go to any hospital within 30 days of having been discharged from a hospital, whether for the reason they were in the hospital originally or for an entirely different diagnosis.
Serious Safety Events occur when a patient suffers a serious event when the staff has done something other than what the normal best practices say they should do.
MUSC is a tertiary / quaternary hospital. This means physicians from all over the state and beyond are referring their patients to MUSC for the most complex surgeries, specialized services not available elsewhere, and treatment for the sickest of patients.
MUSC has 709 inpatient beds, which are almost all in use at any time. That means some new patients may temporarily "board" in the emergency department (ED) or wait in community hospitals until a bed in the right unit becomes available. A new unit called the Express Admission Unit has been set up for patients admitted from the ED who are waiting for a bed to be available on the appropriate unit. Patients can enjoy a more relaxed environment, away from the busy emergency department – and patients needing emergency care can be seen faster. MUSC also has a protocol called the Emergency Patient Placement Protocol that is an emergency plan to create temporary bed space when the patient population in the Emergency Department and in the Operating Rooms reaches a critical level.
MUSC carefully monitors how many patients are in the hospital, ED, and operating rooms, to match the patient care needs with their location and to efficiently move patients "through the system" to free up beds for those waiting. If a patient needs to stay more days to treat their illness or recover from surgery, they will not be rushed. On the other hand, when a patient is safely ready to be discharged, every attempt is made to do that quickly and efficiently. It is our goal to complete discharge orders by 10:00 a.m.on patients ready for discharge, to have patients on their way back to their families or hometowns within three hours of the discharge order.
Here’s how a typical discharge works for both efficiency and patient safety. Pharmacists prepare medications in advance. Social workers and case managers start discharge planning early and make follow-up appointments in advance. A team of discharge nurses calls patients within 72 hours after their discharge to check on their status, assure that patients are taking their medications, following their post-stay procedures and getting to their follow-up appointments.
Here are some of the key "metrics" or statistics that MUSC monitors constantly and works to improve.
Occupancy rate – the percentage of total beds occupied
Average length of stay (ALOS) – in the Emergency Department (ED) for patients discharged from the ED
Average length of stay (ALOS) – in the hospital for patients admitted to the hospital from the ED, once they are admitted
Child and Adolescent Patients
The Children’s Hospital also measures these statistics, to improve the patient experience for children and their families.
Occupancy rate – Percentage of total beds occupied
Average length of stay (ALOS) – in the Pediatric Emergency Department (PED) for patients discharged from the PED
Average length of stay (ALOS) – in the hospital for patients admitted to the Children’s Hospital from the PED, once they are admitted to the Children’s Hospital
While quality and safety are top priorities, let’s face it, the cost of health care is a big consideration.
MUSC has been reporting cost data to the federal government’s Centers for Medicare and Medicaid Services for years. Now we’re taking steps to make financial information available to patients and their families.
You have a right to know what things cost. But that is easier said than done. Hospitals have what they call a Master Charge List. It’s kind of like the rack rate you see on the back of hotel doors. That’s the most the hotel – or a hospital – will charge. The reality is that hospitals are paid what the insurance company has negotiated and will allow. That differs for Medicare, Medicaid, Tricare, private insurance companies (such as Humana or Cigna) or other "payors," as they are called. That can also differ from hospital to hospital, based on a number of factors including such things as the quality outcomes of the hospital, the percentage of patients who have no means to pay, specialized services that are not offered everywhere, and so on.
What you as a patient have to pay also differs based on the terms of your insurance contract. Each plan has a different deductible, different co-pay and different stop loss (the most you have to pay out of pocket).
Ultimately, the amount you pay for any procedure or hospital stay is between you and your insurance company. However, MUSC does want to help make the potential cost for our services clearer to you.
MUSC has signed on with other hospitals who are members of the South Carolina Hospital Association (SCHA) to provide as close to an apples-to-apples comparison of cost for many common procedures.
After studying the best practices hospitals across the country use to provide meaningful data to patients and families, SCHA has decided to implement a program called Price Point.
SCHA will work with the Wisconsin Hospital Association to build and maintain the SC website, using Price Point.
South Carolina will study and move forward with a number of enhancements. These might include:
MUSC is fully supportive of the South Carolina Hospital Association method, because it will provide standardized data that will be helpful as part of the decision process to patients, providers and others interested in managing the costs of health care.