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EDITED BY KIMBERLY LUSTE MARAN Over the past few months, the Washington Post newspaper and other Washington, D.C. area news media have run articles regarding complaints and allegations about patient care issues at Shady Grove Adventist Hospital (SGAH) located in Rockville, Maryland. Executives at SGAH have taken immediate steps to address these concerns at the 263- bed facility, which is part of the Adventist HealthCare system in Columbia Union Conference's eight-state region. Adventist HealthCare is also one of the sponsors of the Adventist Review Online Edition web site "We are proud of this hospital and feel it is offering a valuable health care service to the community," said Ron Wisbey, chairman of the board for Adventist HealthCare. "However, in light of the recent concerns expressed about patient care at Shady Grove, it was absolutely necessary to take pro-active measures." The hospital was initially under fire due to complaints by doctors and nurses that patient care was suffering because of cutbacks in the nursing staff. The tenuous situation of the hospital escalated when complaints by patients poured in. "PRELIMINARY
NONACCREDITAION" Shady Grove is one of Washington, D.C.'s key health care facilities. It operates a major
emergency room that serves a wide swath of northern and central Montgomery County,
Maryland, and draws patients from as far as Frederick County. The hospital has about 1,300 staff
doctors, and the emergency room alone serves 60,000 patients a year. The JCAHO announcement "is not a final decision on the Hospital's accreditation status," says SGAH president Terry White. This is "a preliminary finding based upon a one-day, unannounced survey" on October 22. "The hospital's license to operate is still in good standing." White was brought in as president at SGAH last month when
Cory Chambers resigned as CEO of Adventist HealthCare. White is a veteran
administrator of Adventist health institutions, most
recently in Denver. [Other personnel changes include Kiltie L Loss of accreditation sets a hospital on a path of dramatically increased scrutiny from
state
officials and possible loss of Medicare and Medicaid funding from the U.S. Health Care Financing
Administration. It would also be in danger of losing contracts with dozens of private
health plans,
including health maintenance organizations. As of November 17, Benner has filed the report and Complaints also included medication errors and a chronic failure to note mistakes and incidents in hospital records. According to a JCAHO spokeswoman, the SGAH deficiencies fall into these categories: patient rights, initial assessment of patients, planning and delivery of patient care, organizational performance, leadership, human resources management and training, infection control and the admission of doctors to the medical staff. "We have welcomed the involvement by the state and in fact, have been working closely with them throughout this process in a collaborative effort to address all concerns raised," said Wisbey. "In the last two weeks we have already taken a number of strong, decisive measures to address these issues. An outside review is always beneficial to any hospital administration, as it offers one more fail-safe protection for our patients." Wisbey has been heard throughout the Washington Metro area on local AM and FM stations thanking the community and employees for their support and vowing to enact solutions for the problems plaguing the hospital. CORRECTIVE
MEASURES * A health care consultant has been retained to independently review the hospital's staffing levels, quality improvement plan, and other policies relating to patient care. * A task force of physicians, nurses, and administrators has been appointed to oversee the review
of patient care policies and the implementation of any new measures to correct deficiencies that * A medication administration task force has been formed to carefully review medication processes and make recommendations necessary for improvement. The task force includes pharmacists, staff nurses, and doctors. * Two independent nursing consultants have been hired to access the hospital's nursing practices and make recommendations for improving performance. They joined a consultant already on site to evaluate nursing policies. * A new management structure has been put in place to provide greater oversight of the hospital and improve coordination with the medical staff on patient care issues. * The hospital's "performance improvement process" is being evaluated to ensure that once information about patient care is collected, appropriate action is taken when necessary. "It hasn't been easy to hear the concerns raised, but our overriding responsibility as a faith-based, non-profit health care provider compels us to take action," added Wisbey. "Our goal is a 100 percent error free hospital and we're going to work toward that standard." Wisbey also said that the health care environment in the United States has placed enormous pressure on hospitals to reduce their costs while at the same time continually improving the quality of care. "Even though we face cost pressures, we must make any changes necessary to provide the highest level of care." Steps were taken by the hospital to address concerns that have been raised even prior to the release of the two investigation reports. In fact, Benner mentions in her report that "the hospital has taken aggressive steps to remedy the deficiencies." "I want to assure everyone in our community that this is a safe hospital and we will do whatever it takes to get to the bottom of these issues," commented Wisbey. Whether it's staffing levels, patient care policies, our performance improvement processes, nursing management concerns or any other problems, we will get it resolved." "Shady Grove is a very good hospital," added Wisbey. "We continue to receive strong
support from doctors on our medical staff, our patient census remains strong, and we are very
proud of the work of our nurses and other staff members. We have a very high standard of care Jennie Forehand, the state senator from District 17 where SGAH is located, has released a letter saying, "I have complete faith that the staff at SGAH will get these issues resolved. This is an exceptional hospital and I fully support the changes that administrators, doctors and nurses are developing to make it even better. I would not hesitate to personally receive care at SGAH." Edited by Kimberly Luste Maran, the information in this report is based on press releases from Adventist HealthCare and two articles published in the Washington Post.
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each, formerly chief operating
officer for both SGAH and Washington Adventist Hospital in Takoma Park, Maryland, now
serving as president only of WAH. Wisbey is acting CEO for the health care
corporation and Columbia Union president Harold L. Lee is acting
corporation board chair.]
