Wednesday, September 24, 2008

Move to new hospital risky, Dix staffers say

Move to new hospital risky, Dix staffers say By Michael Biesecker, Staff Writer

More than 30 doctors and psychologists from Dorothea Dix Hospital have sent a letter to their bosses protesting the pending move to a new facility in Butner as premature and risky.

Central Regional Hospital, where the bulk of Dix patients and staff will be transferred in little more than two weeks, still has serious safety and staffing problems, the Dix staff members warn.

Signed by doctors representing the entire medical and psychological staff at Dix, Friday's letter is the second of its kind sent to top administrators at the state Department of Health and Human Services. A similar one in May helped prompt administrators to delay the move to the new $130 million building in Butner, which partially opened in July with the transfer of patients and staff from nearby John Umstead Hospital.

The new letter lists numerous concerns that have since cropped up at Central Regional, including a security system that frequently sends out false alarms and emergency pagers that often don't work. The letter says planned staffing levels in some wards at Central Regional are insufficient and many workers set to handle some of the facility's most dangerous patients have not been properly trained. The letter warns that current conditions at Central Regional would not pass muster with accreditors or federal regulators.

"We appreciate that you incorporated some of the suggestions we made in our previous letter," write the doctors and psychologists, some of whom have already worked shifts in the new hospital and are set to hold managerial positions there. "Nevertheless, we believe that serious questions about safety and treatment programs remain. ... We urge postponement of the move."

Dempsey Benton, the secretary of the Department of Health and Human Services, and other top administrators insist the new facility is safe and that any lingering problems will quickly be fixed.

They argue that it is a far greater risk to patients for the state to delay the merger any longer and that regulators won't accredit the new hospital until the transfer of Dix's patients and staff to Butner is complete.

Health and human services spokesman Tom Lawrence could not be reached Saturday to comment on Friday's letter.

The Dix doctors and psychologists raised particular concerns about wards where children are being treated and the criminally insane will be held.

Due to a lack of space at the new hospital, children and adolescents are staying in a building on the old Umstead campus, about a mile from the new hospital. Under the current plan, that unit is not always staffed with doctors and medical nurses.

In the event of a medical emergency, such as if a child stopped breathing, psychiatric nurses would have to call for help by telephone.
The plan is for a doctor and medical nurse at the new hospital to rush to one of two cars stationed outside doors at the new hospital and drive to the old hospital, according to Michael Lancaster, head of the state mental health division.

In test runs, it took the medical staff up to 16 minutes to respond to a life-threatening emergency on the children's ward, according to internal department e-mails.

The Dix staff also voiced concerns about the yet-to-be-opened forensic unit at the new hospital, which is to house patients either awaiting trial for criminal offenses or previously found not guilty of such crimes as rape and murder by reason of insanity. Their letter says the maximum security forensic unit for men will be staffed by health care technicians "who have not worked in a forensic unit and have not yet received forensic training."
It also cites "very concerning design issues," such as the inability to keep violent forensic patients from entering the nursing station.

In a statement released Thursday, Benton said that Dr. Anthony Lindsey, vice chair of the UNC Health Care Department of Psychiatry, and other experts from UNC and Duke University had determined that earlier safety concerns at Central Regional "had been addressed and corrected." Lindsey said Friday he was surprised to see his name used in Benton's statement.

Lindsey and others toured the hospital in June, before any patients or staff had moved in, and sent a letter to Benton praising progress in fixing issues such as bathroom fixtures that patients could have used to hang themselves.
But the group also cited problems that remained to be fixed and questioned planned staffing levels at Central Regional -- points Benton's statement omitted.

Lindsey said he had not been to Central Regional since June and was not consulted before his name was included in Benton's statement that the new hospital is ready. "We were writing in June solely about the issues with the building," Lindsey said. "We weren't saying anything about how they're running the place." or (919) 829-4698

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