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| Deficiencies found in Dallas' Parkland emergency department |
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The Dallas Morning News, January 18, 2009 - A month after a man waited 19 hours for treatment and then died in Parkland Memorial Hospital's emergency department, a national accreditation group showed up there for an unannounced spot-check. Though officials at the taxpayer-funded charity hospital refuse to discuss that visit, the accreditation group has released a list of 11 standards that it says the hospital failed to meet. One area that was found deficient – "patients have the right to pain management" – suggests that Parkland was not adequately addressing patient discomfort inside the emergency department. But neither the hospital nor the accreditation group will disclose what problem was found. The group also found that the hospital was not adequately defining the timeframe for conducting initial patient assessments. Other standards found deficient included leadership and staff qualifications. The accreditation group, The Joint Commission, is an independent, nonprofit organization that sets standards for the nation's hospitals. Elizabeth Zhani, a spokeswoman for the group, said the Oct. 21 spot-check was prompted by either a complaint or a news story. She stressed that the findings were preliminary and that the hospital has the opportunity to correct deficiencies. Parkland officials emphasized that the hospital remains fully accredited. They said they will be willing to discuss the situation later this month after they unveil a plan to cut wait times and improve care inside the ER. "Our staff is continuing to work with The Joint Commission to address any issues identified during their October survey," hospital officials said in a prepared statement. "The process is ongoing and is not complete at this time." Officials say that the hospital simply has too few beds for the crush of people needing care and that the ER is stuck with much of the overflow. The same problem is found in big-city ERs across the country. 19-hour waits On Sept. 19, Mike Herrera checked into Parkland's ER for his recurring hernia problem. The 58-year-old former restaurateur saw a triage nurse and described the pain in his abdomen as a 10 on a scale of 1 to 10. His vital signs were normal, and he was labeled an "urgent" case, a 3 on an emergency severity scale of 5. He waited 19 hours and then suffered cardiac arrest. He died as ER workers tried to save him. A few days later, a woman with a broken leg spent 19 hours in the hospital's ER, then finally gave up and went home before seeing a doctor. She was furious later to receive a $162 bill, which hospital officials said was standard. After The Dallas Morning News ran a story about the woman's experience, hospital officials rescinded the fee and changed the policy, saying they had determined "it may not be in the best interest of our patients." Since the high-profile death, hospital officials say, Parkland has increased emergency department staff to better manage the flow of patients. And in November, Dallas County voters overwhelmingly approved replacing the 54-year-old hospital with a larger, more modern facility. But Parkland officials refuse to discuss details of their new plan before it is presented to the hospital's board of managers Jan. 27. "Some plan components have been implemented; others will require facility and structural changes and will be implemented within the year," the hospital's statement said. Staying quiet The News asked Parkland to release records related to the October spot-check, but hospital officials have sought to keep them secret. In a five-page brief to the state attorney general's office, they argued that disclosing the records would compromise the hospital's quality-review process. It has not been ruled on. In response to another records request, Parkland released an e-mail sent to employees the day after the spot-check. "There were some recommendations for improvement noted which we are addressing with Senior Leadership and the department," said the e-mail, sent by Parkland Chief Operating Officer John Haupert. The e-mail expressed support for staffers disheartened by all the critical news coverage. "It is human nature to take the negative comments personally," wrote Haupert, who declined to be interviewed. "But I urge you to remember why you came to Parkland. Why our mission and vision are so important. You are among the very best employees in the area and I am proud to stand with you." By STEVE THOMPSON / The Dallas Morning News This e-mail address is being protected from spam bots, you need JavaScript enabled to view it Source: http://www.dallasnews.com/sharedcontent/dws/news/localnews/stories/DN-parkland_18met.ART.Central.Edition1.4ec5e1c.html © 2009, The Dallas Morning News, Inc. All Rights Reserved. » Post Comment
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