Observations
Based on a review of facility policy and procedure, the employee handbook, patient records and interviews with patients and employees, the facility failed to assist a patient in accessing psychiatric care in an efficient and compassionate manner.
The findings include:
The facility failed to ensure that a patient who had exhibited a possible need for psychiatric care was assisted in obtaining that care. The patient was allowed to leave the physical plant after having expressed ideations of self harm. The facility did not officially assist the patient in accessing a psychiatric evaluation.
The Narcotic Treatment Physician did not agree with the finding. The Assistant Program Director stated that the facility investigation of the incident had not been completed and she would not comment on the findings.
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Plan of Correction
It is the responsiblility of the treatment program to assist members who have expressed,or exhibit signs of suicidal or homicidal thoughts or ideation.
The procedure in place requires that the patient be seen by a clinical personnel to include, a therapist, supervisor, or director to provide intital assesment of symptoms.
If warranted, medical staff is alerted to include nursing staff, and then lastly medical staff (psychiatrist or treatment physician).
After consultation and assessment with the medical personnel, the patient is transported via 911 EMS services to the nearest crisis center or emergency room, if assessment by the doctor requires emergency transportation. The program will also contact mobile crisis services to provide a psychiatric evaluation, if warranted.
If patient's symptoms do not warrant emergency transportion (medical decision made by the physician, or other medical personnel), the patient is provided with the nearest hospital information.
All interactions are to be documented in the medical progress note with final disposition.
The Program Director is responsible for ensuring that the above detailed process is followed.
Staff will be re-trained by September 30, 2012 by the Program Director in this process.
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