U.Va. Institutes New Safety and Security Procedures at Medical Center
June 7, 2001
University of Virginia officials today announced a number of actions
designed to improve patient care and safety at the Medical Center.
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, U.Va.s
executive vice president and chief operating officer.
are deeply disturbed by the situations that have occurred,"
he said, "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. 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. "With
the leadership of Medical Center chief operating officer William
E. Carter and his senior management team, we have moved with all
possible speed, given that there are a number of complex medical
and legal issues that required thorough and painstaking analysis."
said the Health Care Financing Administration (HCFA), the federal
agency that administers the Medicare program, notified the Medical
Center yesterday 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 within three to six weeks. Sandridge said he is
confident that at that time, as a result of the actions announced
today, this status will be rescinded.
also announced 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.
Medical Center officials will notify these employees individually.
following administrative and operational changes have been instituted
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, Carter said.
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 week, they noted
that while progress had been made, there are still practices that
need to be changed. "The reviewers said that they had found
no evidence of physical injury to patients with regard to restraints,"
Sandridge said, "but there are still some issues that they
would like us to refine before they approve our corrective action
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. Once these patients are stabilized, they will be transferred
to an inpatient adolescent care facility.
Strengthening the Medical Centers existing sexual assault
reporting policy to better identify and investigate all allegations
of any type of patient abuse, including assault. This includes guidelines
for the clinical and psychological treatment of patients who are
possible victims of assault at the Medical Center, and an official
review mechanism for any sexual assault allegations.
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.
believe that each of these actions is significant and will substantively
improve patient care and safety at the Medical Center," Sandridge
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," he said. "This is part of our role as
the region's 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."