Five Questions
Good morning!
It’s the last Friday of the month so today I’ll answer your questions.
Even after nearly three years of producing VC Notes every week, I continue to receive many questions and comments from you, so thank you. I read and appreciate all of them. I’m not able to answer every question in this column, but I do pass many along to senior administrators for further review and possible action.
Now, on to your questions.
Q: I work in the Medical Mall. Today I went to the Employee Quick Care Clinic on Lakeland and was given a handful of prescriptions. When I got back to the mall, I walked down to the Pharmacy but was told that they don't fill prescriptions from Lakeland Family Clinic. Why in the world not? I'm an employee, I work in the Medical Mall, I went to a UMMC clinic and I saw a UMMC physician, but now I have to go out to another pharmacy to get my meds? This makes absolutely no sense to me.
A: UMMC has three retail pharmacies staffed with highly skilled, hard-working teams. As explained to me, the Pavilion pharmacy is similar to any community pharmacy and fills prescriptions from any provider or location. Our Jackson Medical Mall and Meds and Threads pharmacies only fill 340B-eligible prescriptions. The 340B program is a federal initiative that allows medications to be purchased at reduced prices. To be eligible, prescriptions must meet multiple federal requirements including that both the provider and clinic location are eligible to participate. Employee Quick Care is not a 340B-eligible location. Prescriptions from this location can be filled at our Pavilion pharmacy or any outside pharmacy, but not at our 340B pharmacies. Typically, prescriptions written at one of the main campus hospitals or clinics inside one of the hospitals, Batson Specialty Clinic, or most of the UMMC Jackson Medical Mall clinics are eligible to be filled at our 340B pharmacies. I agree that this is awfully confusing and wish we could make things more convenient for all our employees, but we must abide by the rules of this program that is such a benefit to many of our patients.
Q: Why can't UMMC institute a policy on accountability? I just met with a group of three nurse practitioners who have been here over eight years. Only one of them has ever had an evaluation since they started employment! No wonder nothing ever changes! There is no one holding staff accountable for their jobs!
A: It would be most unusual if your fellow employees have not been evaluated over a span of several years. Health system employees and faculty receive performance evaluations annually. Although we’d like for staff in the academic and research mission areas to be evaluated annually, we’ve had some longer gaps for a variety of reasons. Regular, formal evaluations are important, but assessment of employee performance should occur constantly with meaningful, two-way dialogue between employees and their supervisors and with appropriate guidance or discipline when needed. This is the ideal, but in such a large organization as ours, there can be wide variation in achieving it. With that stipulation in mind, I can say from my vantage point that we do hold our staff and faculty accountable. What we are really striving for, though, is a culture of accountability in which employees at all levels are personally committed to excellence and hold themselves and their peers accountable to that standard. We are not there yet, and we will never be completely there, but I feel like we are headed in the right direction.
Q: Parking is always a touchy subject at UMMC. However, it is quite upsetting to see an entire parking lot being unused in front of the new School of Medicine with so many workers and students walking all the way from the stadium parking lot. Are there any plans to assign employees and/or students to this lot in the near future? A completely unused parking lot in the heart of campus seems like a waste of resources and only makes employees/students more displeased with the long walk from the stadium.
A: Parking is indeed a touchy subject; maybe the touchiest! But there’s usually a good explanation behind how we manage it. The lot in front of the School of Medicine education building is part of the new, larger Lot 3 that will be between the SOM and the Translational Research Center. The contractors are almost finished with the TRC portion of the lot; they just need to stripe the parking spaces, weather permitting. Part of the new Lot 3 will be available for two designated groups: part-time workers participating in our standardized patient program and paying tenants of the innovation incubator suites in the TRC. Once all the construction work is finished, spaces will be allocated for these two groups; then, the UMMC parking policy will be followed to assign the remaining spaces to eligible employees.
Q: With the State Board of Nursing looking at requiring 20 continuing education hours in a two-year cycle of licensure, how does UMMC propose to allow the nurses time off to attend continuing education classes? I work the night shift so I usually would have to take two days off to attend a class because I can't work all night, then sit through an 8-hour class. Most classes seem to be on times I am scheduled to work, making it impossible to do it on my time off. In the "older days" when we had CE hours we could take off with short notice, but these days we have to plan any days off months in advance. There are a lot of RNs and LPNs that work here that soon will be required to obtain these hours. What are UMMC’s proposals?
A: I submitted your question to Dr. Terri Gillespie, head of nursing for our health system, and she provided this response: “While it’s the responsibility of every licensed nurse to meet the requirements for licensure, UMMC and Nursing Leadership are working on plans to help our staff meet this requirement when it is implemented (most likely in January 2019). We are working with the Division of Continuing Health Professional Education to attach CE credit to on-campus educational opportunities such as Brown Bag Lunches, Schwartz Center Rounds and possibly Epic training, among other options. I appreciate the difficulty working at night presents and am hoping to have live and recorded educational offerings at varied times, shifts and venues. We are also exploring the option of having CE credit available through Healthstream. Our managers are aware that there will likely be a need for some employees to take off work to obtain these credits and all efforts will be made to accommodate this. Much more to come on this topic.”
Q: As a new parent, my wife and I have had two occasions to visit our Children's Emergency Department. I am pleased to tell you that on both occasions, we received excellent care from all staff and faculty. Everyone clearly demonstrated that they cared about our son and we can't thank them enough. The second time we visited the Peds ER, it was in the middle of a weekday and just to make sure that our son was OK after a minor fall. It wasn't an "emergency" per se, but it was something that needed to be addressed the same day in case it was serious. After several calls, we determined that UMMC has no "urgent care" facility for children and that the ER was the only option. I was very dismayed to find out that the Eli Manning Clinic no longer provides same-day general pediatric care. When our son was born, we toured the clinic and it seemed to us to be a perfect urgent care clinic. Apparently this facility is now being used only as a specialty clinic, so there is nowhere in the UMMC system for a child to get such care outside of the ER, which is a waste of ER resources (and expensive if you are on state employee medical insurance). Our regular visits occur at the North Clinic, but they require an appointment and almost never have one available the same day. I was told that the Jackson Medical Mall clinic has the same issue. Given that children have minor incidents all the time, this seems like a very large hole in our pediatric offerings. Is there some way that this can be addressed?
A: Our leaders in Children’s tell me they are aware of this gap in our services and have been discussing this very issue for several weeks. A few years ago we developed an after-hours clinic but it often fills up with appointments, leaving some families with the option of either going to the ER or waiting until an appointment is available with their pediatrician. Many children do not need an ER and often need to see a pediatric provider when their physician’s office is closed or an appointment is unavailable. Although some business analysis still needs to be done, I’m told we will be looking at options to develop this needed service in the next fiscal year.
Thanks for this timely suggestion. And thank you all for the many ways you are contributing to A Healthier Mississippi.