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PDH: Understaffing a Possible Factor in Deaths at CRMC

 |  By John Commins  
   August 10, 2011

Chronic understaffing at Carlisle (PA) Regional Medical Center may have played a role in the deaths of at least two emergency department patients in June, a report from the Pennsylvania Department of Health says.

Executives at Naples, FL-based Health Management Associates Inc., which owns Carlisle Regional, dispute the state's findings.

On June 5, a critical care patient at Carlisle Regional died while undergoing a CT scan. An employee told state investigators that the patient was sent for imaging without a nurse because only four nurses were on duty to service the overflowing emergency department.

The employee, identified as EMP4, told state investigators the "that management was aware of the staffing situation throughout the hospital and ED nurses were told that they must be more creative in their care."

On June 11, a patient in the emergency department complained of chest pains, and light-headedness died at the hospital more than seven hours after a cardiologist recommended that the patient be transferred to Harrisburg Hospital for an aortic valve replacement.

The state report reviewed documents from the hospital and includes interviews with at least 18 unnamed employees who complained about poor and unresponsive management and retaliation against "troublemakers."

A report in the New England Journal of Medicine earlier this year found that inpatient mortality goes up significantly when a hospital has greater patient turnover and when it fails to meet its own nurse staffing targets by at least eight hours.

Several employees told state investigators that an emergency department supervisor who had repeatedly complained to management about the chronic understaffing was fired. "We all fear for our jobs because corporate will fire at will with no reason," a hospital worker identified as EMP9 told state investigators. Another unnamed worker said nurses were afraid.  "This is an unsafe place to work and management is aware," EMP18 said.

John Kristel, CEO at Carlisle Regional Medical Center, said in a media statement that the hospital "takes the findings of a recent state Health Department report very seriously."

"However, we take great exception to the notion that the regrettable deaths of two patients may have been related to staffing issues at the hospital," Kristel said in a prepared statement. "We look at our staffing levels on a continuous basis and at this juncture we have no reason to believe that these deaths were in any way connected to staffing levels. Our deepest sympathies go out to the two families involved."

Kristel conceded that "like most other Pennsylvania hospitals, we face challenges with our staffing levels for nurses from time to time." He said the hospital recently hired more nurses, and "will continue to take steps to insure appropriate staffing."

The Health Department requires Carlisle Regional to file a response this week outlining the steps it will take to address concerns raised in the report and correcting any inaccuracies.

"The hospital will meet that deadline," Kristel said. "We will be providing the state a concrete plan of action -- part of which we have already begun to implement -- that we are confident will address the issues that have been raised."
 

See Also:
Inpatient Mortality Linked to Nurse Understaffing
5 Reasons Nurses Want to Leave Your Hospital

 

 

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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