This is an article from the Yakima newspaper that reported on the potential
new Osteopathic school in Yakima on 15Apr05 following the businesswire
article on 14Apr05. The hospital was run by Providence until 2003 when it
was purchased by another company. This company seems to be significantly
understaffing the hospital.
This type of problem cannot be solved by increasing the supply of qualified
physicians, nurses, technicians and other staff.
date: 25May05
source:
http://www.yakima-herald.com/?storyid=289217510811988
Doctors detail safety worries in hospital ER
By CHARLENE KOSKI
YAKIMA HERALD-REPUBLIC
Outraged at allegations they resigned for financial reasons, Yakima Regional Medical and Cardiac Center's emergency physicians confirmed Tuesday that they wrote a document describing more than 25 recent emergency-room incidents that they believe could've been disastrous.
The document, which physicians now verify they wrote collaboratively to demonstrate the need for more staff at Yakima Regional, was sent anonymously last week to local media outlets. Until Tuesday, the physicians would not confirm they had written it, citing labor negotiation restrictions.
That changed Tuesday, when sections of the 13-page memorandum were posted on a television station's Web site, and hospital administrator Tim Trottier was quoted in the Yakima Herald-Republic saying that the doctors' concerns were a tactic to gain financial concessions from the hospital.
"That statement is so ludicrous," emergency physician Marty Brueggemann said of Trottier's comment. "How does it make sense that we're going to give up our pay to make more money?"
Brueggemann spoke on behalf of all the departing ER physicians.
Though the doctors claim Regional administrators brushed aside patient-safety concerns for more than a year, Trottier insisted in a statement released Tuesday night that the hospital has listened to and reviewed the physicians' written concerns. And Regional has dealt with, or is dealing with, any legitimate patient care issues, his statement said.
"Patient safety is Yakima Regional's first priority, and the hospital has a number of processes in place to deal with quality issues," Trottier wrote.
Last week, hospital officials and the physicians' attorney confirmed that all eight of Yakima Regional's physicians were resigning as of midnight June 2. The physicians cited patient safety issues caused by low staffing levels as the reason for their departure.
The physicians were working under a contract they'd established with the hospital's previous owner, nonprofit Providence Health Systems. For-profit Health Management Associates Inc. purchased the hospital in August 2003.
The doctors' contract was through December 2006, but they say they gave 90-day notice to Yakima Regional on March 4 after the hospital failed to adequately address the physicians' staffing concerns.
Frustrated, the doctors who belong to the negotiating group Yakima Emergency Physicians decided to document cases in the emergency room that would support their claims of staffing shortages.
Their hope, Brueggemann said, was that even if they were leaving, patient safety issues might still be addressed.
The doctors recorded about 25 cases that they say occurred in the emergency room between March 2 and April 12, and in late April presented those cases to the hospital's advisory board and administrators, including Trottier.
The document states that the cases presented "are merely the cases that were documented, and represent only a sampling of the events that we are noticing on a daily basis."
Topics addressed in the physicians' memorandum include:
* Cuts in technical, secretarial, pharmacy and intravenous support staff.
* Difficulties with the hospital's computerized record system.
* Mistakes in laboratory services.
* Delays in testing.
* Overworked nurses.
* Unnecessary and risky patient transfers due to staffing shortages.
The doctors complained that nurses are quitting the hospital and being replaced with less-qualified staff; that remaining nurses are being asked to perform too many tasks; and that the renovated emergency room created more space for patients, but that there aren't enough employees to properly deal with those patients.
The physicians also wrote that they were "unaware of any catastrophic outcomes related to the events outlined in this document. However ... it is only a matter of time before one does occur. As such, we feel it is necessary to dissociate ourselves from Regional hospital and to discontinue our practice there due to the conditions we now find ourselves facing."
Trottier, however, insists that care in the hospital's emergency department is first-rate.
In his Tuesday statement, he emphasized that the most current patient satisfaction survey results, taken between January and March of this year, indicate a 94 percent patient satisfaction rate for patient care, and a 97 percent overall rating in the emergency room.
All emergency room patients receive a survey, hospital officials said.
Earlier this week, Trottier announced that national physician recruiting firm EmCare would be filling the vacant physician positions, effective June 3. He said EmCare's expertise will improve care in the hospital's emergency department.
All of the resigning physicians say they've been contacted by EmCare and offered jobs at Yakima Regional. According to EmCare's Web site, the Yakima positions include a "competitive hourly rate" and "generous" signing bonuses.
All of the departing physicians rejected the offers, Brueggemann said.
Who's leaving?
Names of the departing emergency room physicians, and their approximate length of time at Yakima Regional Medical and Cardiac Center:
1. Dave Olson, 25 years.
2. Sam Booth, 20 years.
3. Richard Plunkett, 15 years.
4. Regan Wylie, five years.
5. Michael Hauke, five years.
6. Robert Johnson, three years.
7. Marty Brueggemann, one year.
8. Christopher Rhead, five years (left in April for job in California hospital).
9. Joel Heinzen, 30 years (retired, but has been helping fill in since Rhead left).
WHY THEY QUIT:
A document prepared by emergency physicians at Yakima Regional Medical and Cardiac Center listed more than 25 anecdotes to support their claims of staffing shortages at the hospital. The document, which the physicians sent to Regional administrators and which was mailed anonymously to the Yakima Herald-Republic last week, states that all of the examples occurred between March 2 and April 12. Here are some excerpts:
LABORATORY MIX-UPS "Dr. Wylie had a case of a patient in which she had thought to obtain a (Thyroid Stimulating Hormone) level. This came back markedly elevated, so she went in to give the results to the patient and explain what this meant. The patient listened to her, and then informed her that nobody had ever drawn her blood. It was determined that the result belonged to a different patient, who had already been discharged from the ER ... There are several other cases where the blood of two patients has been switched. I recall one specifically of a small child who was very apprehensive about having his blood drawn in the first place. After the mix-up, we were unsure whose blood was whose, so we were forced to redraw both patients."
RISKY TRANSFERS "A ... trauma patient was seen in the ER after a skiing accident. In addition to a closed head injury, he suffered a C7 fracture in his vertebral column. Although two ICU beds were available, no nurses were available. This patient was transferred to Yakima Valley Memorial Hospital. Although transfers present risks for ANY patient, they are particularly risky for a patient with a potential spinal cord injury, where one wrong movement, or minor traffic accident, could result in catastrophic consequences."
DANGEROUS DELAYS "An 18-year-old pregnant patient presented to the ER with vaginal bleeding and cramping abdominal pain documented ... Her presentation time is documented as 19:15. After triage, she was returned to the waiting room where she sat for about 90 minutes waiting for a room. At 20:40 the Emergency Department Physician went into the room and found the patient crying and still with her clothes on. No pelvic equipment was available and the patient was placed in a 'fast track' room where she was not in sight of any nursing station. An ultrasound was ordered and the patient was diagnosed with an ectopic pregnancy. After consultation with OB/GYN, methotrexate was ordered. However, since there was no nighttime pharmacist, and because the nursing supervisor is not allowed to get that particular medicine, it had to be ordered from the Yakima Valley Memorial pharmacy and a courier had to be sent to pick it up. The courier was the (emergency department) secretary!"
OVERWORKED STAFF "A 76-year-old patient with a history of congestive heart failure presented at 20:09 with 'shortness of breath'... This patient had a documented allergy to latex, as noted on the triage form. She was also sick... A latex-free cart was requested, but nobody seemed to know where to find it. A makeshift cart was put together in the ER by the nurses, but they were not able to get to the cart until 22:05, two hours later! Delivering the latex-free cart was the responsibility of the nursing supervisor, who was tied up with other duties."
GENERAL DETERIORATION IN CARE "A 39-year-old patient was placed by an outpatient employee in a room that had not yet been cleaned or prepared by staff after the last patient had occupied it. The Emergency Department Physician went into the room and found the patient sitting in a chair. The bed was still dirty, there were cups, used tissues, and bodily fluids in the room that had not been cleaned up yet."
Did you notice they also said "Three others are currently seeking accreditation, but for now the closest existing osteopathic medical school is in Vallejo, Calif. "
I hope this wouldn't happen (and can't see it happening soon), but I'm sure others have had similar nightmares. Here's hoping that the AOA turned down the joint match for a reason which they had been hiding up their sleeve, and not merely because of what seems to be an arrogant and reactionary position. 🙄 
