Although he wouldn't admit to feeling vindicated, Yakima (Wash.) Regional Medical and Heart Center Chief Executive Officer Tim Trottier acknowledged that he was pleased by the findings of a state Department of Health investigation of his facility triggered by charges that patients were being put at risk.
"We are very grateful that we now have accurate information to present to the public about the quality of care that we offer," Trottier said.
The state publicly released its report Tuesday afternoon, and Trottier said it provided evidence that allegations of patient-safety risks were unfounded.
The eight physicians belonging to the Yakima Emergency Physicians group resigned at midnight on June 2 after citing unresolved patient-safety concerns caused by staffing cuts and difficulties with the hospital's new computerized records system. These concerns included mistakes in laboratory services and a risky patient transfer. The doctors were replaced immediately by physicians hired by EmCare, a Dallas-based emergency medicine management group.
The state health department conducted a 16-day investigation in which it reviewed records, interviewed staff, and made on-site observations of the emergency department. At the same time, the College of American Pathology and the CMS performed a joint, unannounced inspection of the hospital laboratory.
Three citations were issued:
The report stated that an allegation of a trauma patient being put at risk by an unnecessary transfer to another hospital was shown to be untrue. According to the report, the patient was admitted to the medical center's intensive-care unit. It also stated that the hospital's infection-control program and computer system functioned appropriately.
The report noted that no patient harm resulted from any of the verified allegations or citation issues. Byron Plan, executive manager of the state Office of Health Care Survey, characterized the citations as being for isolated incidents rather than systemic problems.
"The hospital is going about its business appropriately," Plan said. "It's recognized that it's made some errors and it is going about correcting them."
The attorney for Yakima Emergency Physicians, Brendan Monahan, disagreed with Plan's assessment and said that the delays and mistakes were symptoms of the staffing concerns his clients originally raised.
The medical center, which is owned by Naples, Fla.-based Health Management Associates, has 10 days to present a corrective action plan or have one imposed on it by the state. Plan said a 60-day progress report will follow to evaluate whether the corrective actions have been effective.
Trottier said corrections already have been implemented, including training more staff to do EKGs so they can assist if the ER staff cannot do all the procedures needed within 10 minutes.
The report also stated, however, that deficiencies within hospital laboratory services "do seem to indicate systemic problems."
According to College of American Pathologists investigators, "universal precautions" were not followed in the handling of infectious materials. It was noted that a lab technologist was seen holding an open serum tube without wearing gloves, while others were seen drinking soda in a break room and observed in a restroom wearing their lab coats, the CAP report said.
The report also gave details of how the lab's quality-management plan has not been implemented as designed and suffered from a lack of documentation and from quality indicators going unmonitored.