Center revises security policies
officials have announced a number of actions designed to improve
patient care and safety at the Medical
Center. These actions are the result of an extensive internal
investigation conducted in the wake of allegations of sexual assaults
and improper use of restraints on the psychiatric unit, said Leonard
W. Sandridge, executive
vice president and chief operating officer.
are deeply disturbed by the situations that have occurred and
have investigated not only what happened, but more importantly,
what we must do to restore the trust of our patients, their families
and the community we serve, he said. We all regret
and apologize for what has happened.
patients deserve safe and effective care and we intend to provide
it, consistently, in all units and departments, he said.
Medical Center officials have rehired three of the
nine employees who were terminated.
Six of the dismissed employees have sued the Medical Center
in U.S. District Court in an effort to get their jobs back.
Rudolph Thomas Johnson Jr. has been charged in a second
sexual assault at the Medical Centers psychiatric
said the Health Care Financing Administration (HCFA), the federal
agency that administers the Medicare program, notified the Medical
Center on June 6 that the institution was being placed in immediate
jeopardy status, which could result in loss of Medicare
reimbursement, due to situations on the psychiatric unit. HCFA
reviewers will conduct a re-inspection prior to July 3.
said he is confident that at that time, as a result of the actions
announced June 7, this status will be rescinded.
also said that a review of the recent dismissals of nine temporary
or probationary employees who had felony convictions and who also
failed to provide complete information on their applications showed
that three of them are eligible for rehire in appropriate positions.
following administrative and operational changes were instituted
the first week of June:
Tightening the management of the psychiatric unit. Pamela F. Cipriano,
the Medical Centers chief clinical officer, will assume
direct clinical and managerial oversight of the unit. In addition,
Sandridge will appoint a team of outside experts, including national
leaders of best practices for use of medical restraints. The team
will work directly with Sandridge and senior management to review
all clinical and managerial practices and policies.
Adding staff on the psychiatric unit to enhance round-the-clock
patient monitoring. At night, two people, one of whom will always
be a female, will conduct patient checks every 15 minutes. The
additional staff also will allow more careful determination of
when patients should be placed in or removed from restraints,
Working with HCFA to finalize new policies and procedures regarding
the appropriate use of patient restraints. A new set of policies
and procedures was developed in January after HCFA ruled that
the Medical Center was not in compliance with federal regulations.
When HCFA reviewers conducted a site visit earlier this month,
they noted that while progress had been made, there are still
practices that need to be changed.
To address concerns about having a combined adolescent-adult inpatient
psychiatric unit, for the immediate future the Medical Center
will no longer accept adolescents for inpatient care, except on
an emergency basis when they need to be medically stabilized.
When this occurs, additional staff will be reassigned to increase
monitoring of these patients.
Strengthening the Medical Centers existing sexual assault
reporting policy to better identify and investigate all allegations
of any type of patient abuse, including assault.
Making permanent a policy that if an employee is accused of criminal
or serious misconduct on the job, he or she will immediately be
reassigned, suspended or put on administrative leave while a Medical
Center and/or police investigation is conducted.
Increasing scrutiny in the hiring process. New hiring policies
require criminal record checks to be completed before job applicants
can be offered a position. Applicants with criminal records will
be evaluated on a case-by-case basis and may be hired for appropriate
positions, but those who falsify employment application information,
including omitting significant events or providing inaccurate
information about criminal convictions, will not be hired.
a longer-term basis, the Medical Center senior management team
is evaluating all possible options to be able to provide psychiatric
care for both adolescents and adults. Our ongoing goal has
been to meet the needs of the community by providing inpatient
psychiatric care for all patients who are referred to us, especially
since Charter Hospital closed, Sandridge said. This
is part of our role as the regions major medical facility
and certainly is what families and medical professionals expect
of us. However, there are many issues, including physical facilities,
regulatory requirements and staffing constraints, that must be
carefully evaluated before we make a final decision. We will work
closely with regulators from HCFA and the state Department of
Mental Health, Mental Retardation and Substance Abuse Services
in evaluating these options.
I would like to extend my gratitude to the Medical Center employees,
who are most distressed by these events. I hope that the issues
we have been dealing with do not overshadow the dedicated and
committed work of the thousands of employees who daily give their
best, who put patients and families first, and who do all that
they can to improve the health and lives of the people they serve.