Patients are our top priority. It's a familiar refrain from hospitals and healthcare organizations, and rightfully so. Offering high-quality care and creating a safe and pleasant environment for patients should always be our overriding goal.
One way many hospitals have tried to bolster the level of care is through employee drug testing. By conducting pre-employment drug screenings, these hospitals can avoid hiring employees whose skills may be impaired or compromised by drug use, thereby potentially endangering the lives of patients.
At Zale Lipshy University Hospital in Dallas we take drug testing a step further by conducting both pre-employment and random drug tests on our employees. We implemented this policy when we opened our doors in 1989 on the campus of the University of Texas Southwestern Medical Center at Dallas, whose faculty physicians practice at Zale Lipshy.
Pre-employment drug testing is a screening tool to help us hire the best employees and discourage those with drug problems from applying. We also believe random drug tests help us maintain a safe environment for everyone and ensure that all employees are in suitable mental and physical condition to perform their jobs safely and satisfactorily. Random tests help send a clear message that we are a "zero tolerance" facility, which we believe is crucial to maintaining our reputation and high standards.
Here's how our testing process works. All prospective employees are required to give a urine sample, which is screened for traces of amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, methadone, methaqualone, opiates, phencyclidine and propoxyphene. All tests are confidential. Applicants who test positive are ineligible for employment.
All hospital employees are considered for random drug testing; a computer program selects candidates. Employees selected for the screening are required to take a drug test for both illegal and prescription narcotics at the date and time indicated. Failure to submit and/or pass the test results in termination. Additionally, an employee who files for workers' compensation or returns from a leave of absence must submit to a drug test. An employee reasonably suspected of substance abuse also will be tested.
Hand in hand with our drug-testing policy is our support of treatment and rehabilitation for the use or misuse of drugs, inhalants or alcohol. Any employee who voluntarily informs management of drug or alcohol dependence is eligible for rehabilitation assistance, which is covered by health and short-term disability insurance. Employees in a formal treatment program are granted a leave of absence, and those who complete treatment return to active employment status, without reduction in pay or seniority. Zale Lipshy also encourages employees to disclose any prescription medications they are taking.
The results of our screening policies have proved beneficial and surprisingly uncontroversial within our organization. While only a few people have tested positive, the program has been significant in helping us ensure that all our employees are drug-free. In addition, some of our employees have been able to receive counseling after voluntarily declaring dependence problems. All employees who have completed rehabilitation have retained employment.
But as pleased as we are with the results of our drug-screening policies, we are dismayed that our standards are not required of all hospitals by healthcare regulatory agencies, including the Joint Commission on Accreditation of Healthcare Organizations and the Occupational Safety and Health Administration.
Many other hospitals in the Dallas area conduct pre-employment and for-cause drug tests, but random drug testing is rare.
This is puzzling. Regulatory agencies such as JCAHO, OSHA and the Commission on Accreditation of Rehabilitation Facilities enforce rigorous standards for employee competency and adequacy in myriad areas. Employees also are required to know safety rules for their work environments. Given these and other standards that many agencies address, why would they fail to include drug testing-an area that deals with employee competency and coherence in its most basic form?
Concern for patient safety certainly should drive more agencies to be concerned about the effects of illegal drugs and alcohol. Our workplace is an environment where lives are at stake and clear-headed judgment is paramount. What better way is there than drug testing to protect patients and staff from employees whose skills or judgment may be impaired?
Another challenge is the drug-testing policies of some nursing agencies. Some agencies conduct their own drug testing on contract nurses or allow for the hospital to test them, but others have no policy. This puts the hospital in a bind. Contract nurses ought to be required to undergo drug testing just as an employee would.
We urge all healthcare regulatory agencies to re-evaluate their standards and mandate pre-employment and random drug testing at all hospitals. It only makes sense.
Robert Smith is president and chief executive officer at Zale Lipshy University Hospital in Dallas.