CLINICAL

MUSC Medical Center (rev. date: 9/07)

The MUSC Medical Center currently has 596 licensed beds in four inpatient facilities—Medical University Hospital, MUSC Children's Hospital, Storm Eye Institute, and the Institute of Psychiatry. For the 10th consecutive year, MUSC was selected for the National Research Corporation’s Consumer Choice Award in 2007-08. The Children’s Hospital ranks in the top 30 nationally for overall pediatric care and in the top 9 for pediatric emergency services in Child magazine’s biannual survey (Feb. 2007). In addition, the National Association of Children’s Hospitals has recognized MUSC’s Medically Fragile Children’s Program as a national model. The Storm Eye Institute is the only comprehensive eye center in South Carolina. The Institute of Psychiatry includes a 6-story building housing a number of behavioral and clinical programs connected to a 105-bed psychiatric hospital with special facilities for children, adolescents, elderly and individuals with addictive disorders. The Medical Center has a comprehensive range of specialized care centers, such as the Heart and Vascular Center, Digestive Disease Center, Hollings Cancer Center, Transplant Center, Center for Alcohol and Drug Programs, and a Level I Trauma Center. . In FY2006 the American Society for Bariatric Surgery named MUSC a Center of Excellence, and the Scientific Registry of Transplant Recipients ranked the Cardiac Transplant Program 1st in the Southeast and 2nd in the nation in one-year survival rates. Medical Center data for the year ending June 30, 2007 include: 

           In October 2007 MUSC will occupy the first phase of a major project to replace the Medical University Hospital, which opened in 1955. Phase I of the new University Hospital is a structure of approximately 641,000 ft2, providing state-of-the-art surgical, medical and diagnostic facilities with 156 additional licensed beds that plans to open for patient care in January 2008. It will initially support the clinical programs of the Cardiology/Cardiovascular Surgery Services and the Digestive Disease Center. Phase 1 includes a new central energy plant as well as significant infrastructure and roadway improvements. Special features in the new facility include a patient and family resource center, dedicated spaces for academic and other clinical care teams, and an enhanced automated records system. For Phase II, an innovative partnership with the Department of Veterans Affairs and the local Ralph H. Johnson VA Medical Center is being explored at the local and national levels (‘the Charleston Model’). Ultimately, the entire replacement hospital will occupy approximately one million ft2 and cost about a billion dollars.

Medical Center Research Mission. The Medical Center mission is to provide excellence in patient care, teaching, and research in an environment that is respectful of others, adaptive to change, and accountable for outcomes. The Medical Center advances biomedical knowledge by serving as a setting for clinical and translational research, providing resources to conduct research, and offering opportunities for patients to participate appropriately in research and treatment protocols.

Hospital Accreditation. The most recent Joint Commission on Accreditation of Healthcare Organizations (JCAHO) survey in September 2006 resulted in full re-accreditation. MUSC Medical Center is fully licensed by the South Carolina Department of Health and Environmental Control (SC DHEC).

Access to Patients. The MUSC Medical Center has managed care contracts with all major commercial payers in its area. The tri-county Charleston area is the state’s fastest growing region with a population of 554,000 in the primary area and another 540,000 in the secondary market. A quarter of the state’s senior population lives in these catchment areas. As South Carolina's premier health care center, MUSC receives statewide and regional referrals through consortium hospitals, satellite clinics, and an extensive network of referring physicians. Data regarding inpatient and outpatient activity are provided above.

Computerized Clinical Data Management System (rev date 09/07).
MUSC's electronic medical record system has two primary components: a clinical data repository from Emergis called Oacis, and an outpatient medical record documentation system from Physician Micro Systems, Inc. called Practice Partner. MUSC also utilizes Lanvision's AccessAnywhere document imaging system. Clinical information and results are integrated in Oacis from Practice Partner and Lanvision, as well as numerous other sources such as general laboratory, microbiology, pathology, radiology, respiratory therapy and multiple sources of transcription. Additional interfaces to other data sources continue to be developed. The Oacis system is designed on a service-based model as a longitudinal patient record for both inpatient and outpatient information. The collection of data in the Oacis system at MUSC started in June 1993. With authorization, professional staff can access detailed data on a given patient or a group of patients. The Oacis system supports clinical decision-making and serves as a repository for data associated with clinical, health services, and outcomes research. In August 2005, MUSC signed a contract with Picis Corporation to automate MUSC's Operating Room clinical documentation. In September 2005, MUSC signed a multi-year contract with McKesson Corporation to replace the Oacis system and implement additional clinical systems capabilities, such as computerized physician order entry. The first phases of the McKesson system went 'live' in September 2006 and will continue through 2008.  Similarly, the Picis system is being activated in phases beginning in early 2007.

Charleston Memorial Hospital (rev. date 9/07)
http://www.musc.edu/medcenter/cmh/
Charleston Memorial Hospital (CMH) is a short-term inpatient facility licensed for 113 beds, providing emergency room services, ancillary department support, and limited inpatient services. MUSC Medical Center purchased CMH from Charleston County in July 2001. This facility provides support for a number of academic, clinical, research, and facility support initiatives at MUSC.

Ralph H. Johnson Veteran's Administration Medical Center (rev. date 9/07)
The Ralph H. Johnson VA Medical Center (VAMC) in Charleston, SC offers primary, secondary, and tertiary care facility and operates 117 inpatient beds. The facility provides a full range of patient care services to veterans along the South Carolina and Georgia coast from North Myrtle Beach to the Savannah area, including acute medical, surgical, and psychiatric inpatient care as well as primary and specialized outpatient services and nursing home care. For the most recent fiscal year, the total number of inpatients treated was 4,203 and the total number of outpatient visits was 414,285. The Charleston VAMC is closely affiliated with MUSC. For FY2005-06, the VAMC supported 78.5 House Staff positions. Residents from MUSC rotate through all major clinical services, as do student trainees and trainees from nursing, pharmacy, social work, and other allied health positions. The Research Service at the Ralph H. Johnson VA Medical Center Center is broad-based with more than 184 active research protocols being conducted by 71 investigators. A unique partnership between the VAMC and MUSC maintains the nation’s only mutually supported research facility, housing collaborative biomedical research with an FY07 extramural funding level of about $20 million (approximately $5.4 million from the VA, $12 million from the National Institutes of Health (NIH), and $2.9 million from other sponsors). VA investigators have wet bench laboratories totaling more than 46,000 ft2 in the Thurmond Biomedical Research Facility. Major research areas include hypertension, diabetes mellitus, heart failure, stem cell biology, cholesterol, cancer biology, renal diseases, signal transduction, mental health, substance abuse, and aging. The Ralph H. Johnson center has one of only six national VA Targeted Research Enhancement Programs (TREP); it focuses on racial disparities in health care. Outpatient clinical/translational research activities are housed in a dedicated 2,800 ft2 Clinical Research Unit (CRU) on the 2nd floor of the VAMC. The CRU has 10 examination rooms, a 4-station transfusion room, a 3-station physician workroom, a waiting room and a general laboratory with a –80ºF freezer, centrifuge, several refrigerators, and a microscope.  The CRU also includes a sterile specimen storage facility, staff offices, and break- and workrooms.

Protection of Human Subjects (rev. date 1/07)
Participation of human subjects in research is under the jurisdiction of federal regulations (45 CFR 46 and 21 CFR 50 and 56). MUSC investigators are granted the privilege of working with human subjects under normal assurance to the government that such research complies with regulations protecting human subjects. The university has a federal-wide assurance for research with human subjects (FWA 00001888, 02/06/2002-10/06/2008), and is in compliance with federal policy governing use of human subjects. Individuals involved in human subject research at MUSC are required to complete the Collaborative IRB Training Initiative (CITI) offered on-line by the University of Miami. All human subject protocols are reviewed through an academic Institutional Review Board (IRB) process. The MUSC Office of Research Integrity coordinates the activities of three IRB committees, involving faculty members as well as representatives of the business, legal, ethical, religious, and civic communities. These committees are registered at: http://ohrp.cit.nih.gov/search/fdasurdtl.asp?asurnum=FWA00001888. The MUSC IRB serves as the university affiliate for the Ralph H. Johnson VA Medical Center, which is accredited by the National Committee for Quality Assurance.

Compliance (rev. date 10/07)
The MUSC University Compliance Program (http://research.musc.edu/compliance/home.htm) is a proactive program to ensure full compliance with all applicable policies, procedures, laws and regulations. This involves a confidential Compliance Helpline to encourage all members of the MUSC community to ask questions or voice concerns about laws and regulations on such topics as coding and billing, research integrity, professional ethics, human subjects, animal research, biological safety, conflict of interests, and patient confidentiality. The program office proactively trains employees and facilitates discovery of concerns, followed by appropriate investigation into problem areas and timely resolution of issues. This program directly assists MUSC’s management at all levels in maintaining and enhancing an environment where ethics are paramount considerations in strategic and operational decisions throughout the organization.

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