The Regional Medical Center's leaders say they’re working to address the failing safety grade the hospital received last month from a national health care watchdog group.
"Where we are, we didn't get there overnight. We didn't. When we get an A, we won't get there overnight," RMC President Charles Williams told people who gathered for Tuesday’s public forum at Orangeburg-Calhoun Technical College’s Roquemore Auditorium.
“I am asking that we pull together, learn from the past, build on the present and grow in the future," he said.
The Leapfrog Group gave RMC an F in its fall 2018 survey of hospital safety across nation. The nonprofit looked at about 2,600 hospitals.
Leapfrog’s survey says the hospital performed below average in 23 out of 28 patient safety measures, above average in four safety measures and average in one safety measure.
RMC was the only hospital out of the 46 surveyed in the state to receive an F. It was also just one of 22 hospitals to receive an F grade in the nation.
Hospital officials say they’ve implemented a number of measures to address the concerns, including developing annual safety surveys, a new patient safety committee, quarterly staffing plans for nursing and quarterly hand hygiene improvement plans.
"Our trajectory is in the right direction," RMC board Chairman the Rev. Dr. Caesar Richburg told those gathered. "If you can imagine the institution as the Titanic in open waters, the reason it hit that iceberg is because it can't turn on a dime. It takes time to turn a culture. It takes time to make that paradigm shift, but it is consistently being done."
The Leapfrog data primarily covered a time period from 2015 until 2017. Data from 2018 was submitted by RMC in June.
Hospital officials noted the lag time between publicly reported data and what happens on the ground.
"It will take some time for the improvements we are making today to be reflected in our score," RMC Interim Director of Quality Medical Staff Services Mickey Whisenhunt said.
Williams said despite the fact that the Leapfrog survey covered from 2015 until 2017, the hospital did see successes during that time period.
The hospital won the Blue Cross Blue Shield Blue Distinction award for its maternity care unit.
The South Carolina Hospital Association presented RMC with three zero-harm awards for no central line-associated bloodstream infections in intensive care, zero knee replacement surgical site infections and zero abdominal hysterectomy surgical site infections.
Also, the hospital's "Get with the Guidelines" program received a gold honors for stroke and congestive heart failure and silver honors for recitation.
The gold recognizes 24 months of performance in quality areas and silver recognizes 12 months of performance in quality areas. In 2018, all three will become gold, Whisenhunt said.
Both Whisenhunt and Williams said the hospital's failing grade does not tell the whole story.
The Leapfrog score is divided into two sections, with half its score related to process and structural measures. The other half covers what actually happens to the patients when they receive care.
"Between an F and an A score, there is only 1.5 point difference in the scoring," Whisenhunt said. "It is a very narrow range."
While certain Leapfrog benchmarks may not have been addressed before he arrived, Williams said the survey will be done as required by Leapfrog under his leadership.
"If there is something out there that we are going to be graded on and the public is going to see it, we shouldn’t say it is not valid," Williams said. "We need to step up to the plate and ask ourselves the question: What is the recommendation and try to live up to that test."
Williams said the Leapfrog survey is one of many.
"The reason why Leapfrog is given so much attention is it is funded by the big employers and the big payers. The insurance companies, the Fortune 500 companies. Their goal was, ‘We want to find a way to save on our health care costs,’" he said.
Williams noted the hospital is fully accredited by the Joint Commission.
"All of our programs are accredited and approved by the highest accrediting agency there is,” he said.
Orangeburg County Councilwoman-elect Deloris Frazier praised the care she has received at RMC and asked how the community can help the hospital.
"Begin to build us up," Williams said. "We need to start saying the good things that are happening at RMC. When you hear someone bashing your health care system, call them out. Think about what happens if the RMC is not successful to this community."
"If there is something that is wrong, report it in a way to the people who can make a change," Williams said. "Don't slap it on Facebook. Don't put it on Twitter. Guess what? Twitter is not going to help you. Twitter is not going to see one patient. Twitter is not going to make one change."
Orangeburg resident Leona Brewer said she went to the RMC's emergency department during her three transient ischemic attacks. The attacks have stroke-like symptoms and require immediate medical attention since they can precede strokes, according to the Mayo Clinic website.
"I waited 45 minutes," Brewer said. She said children with bloody noises and coughs went before her.
She left the hospital with her husband and he drove her to Charleston's Medical University of South Carolina.
"I rather drive 10 miles than 100 miles, but I will take what I can at 100 miles because I have nothing good to say about this hospital because of my experiences," Brewer said. "I think if I would have stayed over that 45 minutes, I would be dead."
Williams said, "We are going to work to improve those processes. I want to talk to you. We want to talk to other people in the community."
Because emergency rooms are increasingly being used as primary care offices, Williams said the hospital is looking to build an urgent care center within the next 15 months to 18 months to help reduce the emergency room load.
Georgia resident Sonya Avery said she also has received care at RMC emergency room.
"They immediately triaged me, they did an EKG, they saw I was not suffering from heart-related issues, then they treated me," Avery said. "I cannot say enough good things about the way the emergency department treated me."
"I live in the Atlanta area and I have access to a lot of large health care organizations and I can say the treatment I received at RMC was on par with any of the excellent organizations in that area," she said.
An Orangeburg man with a prior kidnapping conviction is facing new charges after he allegedly broke into his ex-girlfriend’s house, forced her to engage in sex and threatened to cut her heart out with a knife.
Kenneth Zane Crosby, 36, of 6911 Kips Lane, is charged with first-degree burglary, kidnapping, first-degree criminal sexual conduct and first-degree domestic violence.
He appeared before Orangeburg Municipal Judge Virgin Johnson on Wednesday morning.
Johnson took Crosby’s prior kidnapping conviction into consideration, in addition to the seriousness of his new charges, before telling him that a circuit court judge would need to set his bond.
Crosby is accused of grabbing a metal folding ladder from his ex-girlfriend’s vehicle and using it to climb into her bedroom window around 7:30 a.m. on Nov. 27, according to arrest warrants and an Orangeburg Department of Public Safety incident report.
He’s accused of grabbing the woman by her leg and dragging her through the home, causing injuries to her back and arm.
He allegedly forced her to have sex with him.
Warrants also accuse Crosby of holding a knife and threatening to cut out her heart.
Warrants say he, “reached out as if to cut her throat and cut the collar of her shirt and held her leg while threatening to cut her toes with the knife he had in his hand.”
Crosby has a previous kidnapping conviction from Feb. 3, 2017. It stems from an Aug. 2, 2016 robbery that left a man bound in duct tape.
At that time, Circuit Judge Diane Goodstein sentenced him to 10 years in prison, suspended to three years of probation.
She gave him credit for time he’d already served at the Orangeburg County Detention Center and stipulated that his probation would end early upon the payment of all court fees and fines.
Crosby was not on probation when ODPS officers arrested him on Tuesday.
If convicted of first-degree burglary, Crosby faces life in prison.
If he’s convicted of kidnapping and first-degree criminal sexual conduct, Crosby faces a maximum of 30 years on each charge.
A conviction of first-degree domestic violence carries a maximum of 10 years in prison.
The Regional Medical Center brought in more money than expected in October, the first month of its new fiscal year.
"I think we can all agree that we are moving in the positive direction," RMC Chairman the Rev. Dr. Caesar Richburg said during last week’s board meeting.
"We are in a much better position than we were opposed to 10 to 12 months ago,” he said.
RMC saw gross patient revenues of $74.2 million for the month of October, which is about $5.5 million more than the hospital budgeted, according to information provided at last week’s board meeting.
After deductions, the hospital had total net revenues $19.5 million for the month. That’s up about 4.3 percent from the budgeted amount of $18.4 million.
With total operating expenses at $18.7 million for the month, the hospital saw a gain of about $762,000.
The hospital has seen a reduction in its use of the more expensive contract employees.
For the month of October, RMC had 31 contract employees compared to about 82 last October.
The 31 contract employees is the lowest number the hospital has had in a year.
The entire system -- including the RMC's primary care practices – made $732,263 in October. Last October, the hospital system had total loss of about $900,000.
In other matters:
• Trustee Gladys Arends said there are three local students who are participating in the hospital's fall Nurturing the Pipeline program.
The program is a collaborative effort between RMC and local colleges. It’s designed to encourage underrepresented minority students from South Carolina, especially Orangeburg and Calhoun counties, to stay in the state to attend medical school.
The three students are Claflin University junior Daniel Farquharson, who is interested in becoming a traveling doctor; South Carolina State University junior Myrandi Roper, who wants to become an OB/GYN nurse practitioner and Jarret Houston, who is interested in going into research.
The program includes job shadowing opportunities for the students.
"We certainly wish these young people well and we also hope that when they complete their medical training, they'll come back here to practice," Arends said.
• Trustees entered into executive to discuss a number of items, including the recent Leapfrog survey. The hospital received an F for patient safety. The hospital was the only one of 46 surveyed in the state and one of 17 nationally to receive a failing grade.
According to the meeting agenda, Interim Director of Quality Management and Medical Staff Services Mickey Whisenhunt provided trustees with an update on the survey; risk management/patient safety; nursing workforce and hand hygiene.
There was no discussion about the survey or its results in open session.