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Tampa General won't see cuts in Medicare funding

TAMPA — Tampa General Hospital has fixed safety problems endangering psychiatric patients there, federal officials said Friday.

After a four-day investigation, surveyors have signed off on the hospital's plan to improve safety in its psychiatric unit, ending the threat to stop Medicare funding to the hospital.

Two psychiatric patients killed themselves in the same room at Tampa General within two days in July, prompting a government investigation. The hospital flunked that investigation, prompting the Centers for Medicare and Medicaid Services to declare the hospital's patients "in immediate jeopardy."

Tampa General had until Saturday to fix the problems. The centers signed off earlier this week on the hospital's plan, but Tampa General wasn't in the clear until investigators checked to make sure the fixes are real.

"We've had seven surveyors here for the past four days, and they've reported that every issue that was raised has been addressed," hospital spokesman John Dunn said. "They are comfortable with the care we are providing on that unit."

At the Centers for Medicare and Medicaid Services, spokeswoman Lee Millman also said the hospital had passed inspection.

"At Tampa General, the immediate jeopardy was removed, and there were no conditions out of compliance," she said.

The hospital released its 86-page plan detailing changes it made in the psychiatric unit.

Top hospital officials "accept responsibility for the untoward events," the report said, "and have put together a comprehensive plan that will restore the public trust by providing a safe environment for these patients."

Changes include:

• Hiring more mental health counselors.

• Hiring a psychiatric nurse to develop patient safety programs.

• Training staffers on handling psychiatric emergencies, assessing patients' suicide risk, and other issues.

• Formalizing an agreement with the University of South Florida to give its psychiatrists a greater role in the unit's daily operations.

• Replacing closet and bathroom doors with doors designed for safety.

• Adding video monitoring in all patient rooms and other parts of the unit.

• Enacting a patient dignity policy that those who need constant observation would be assigned a specific staffer and would be allowed to sleep in rooms, not hallways.

• Having the nurse in charge conduct an unannounced inspection during each shift, reporting all findings to the hospital's nurse manager.

• Changing the old system of 15-minute checks on patients to one that varies between 5, 10 and 15-minute checks.

• Moving a cleaning supply closet outside the patient care area.

Tampa General also hired a former psychiatric chief of Massachusetts General Hospital as a consultant to make changes.

In the report, hospital officials said they provided staff training, counseled patients and made immediate changes on the day of each suicide. Investigators had criticized them for failing to do so in the first federal report. But the real problem was sloppy documentation, Tampa General officials said.

"Changes occurred rapidly … and staff actions relative to patient care took precedence over the opportunity to document educational efforts," the report said.

In the federal report, investigators also questioned whether it took staffers too long to respond — up to 33 minutes — to the second patient's suicide, or whether the incident was badly documented.

In its report, Tampa General said staffers failed to write down one safety check. On the next safety check, the patient was found hanging, so that it actually took up to seven minutes to call for a code team and four more minutes for that team to arrive.

The Centers for Medicare and Medicaid Services also criticized the hospital for how few staffers completed extra training following the suicides. The report says all psychiatric staffers, as well as nearly 5,000 total employees, went through training on psychiatric safety "to demonstrate TGH's commitment to providing safe psychiatric care."

Lisa Greene can be reached at greene@sptimes.com or (813) 226-3322.

Tampa General won't see cuts in Medicare funding 09/05/08 [Last modified: Sunday, September 7, 2008 10:00am]
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