Posts Tagged ‘Arizona State Hospital’

ADHS SWAT Team Strikes

April 17th, 2014

ASH recheckLast week the ASH Pharmacy began having problems with the computer system that the medical staff use to order prescriptions for patients.  Orders weren’t consistently showing up on the pharmacy computer screen or printing out.  We implemented our back-up system right away, but the temporary work-around was time consuming.  Our Information Technology team made this their highest priority to figure out what was wrong and fix it.

Our I.T. team and our vendor (Netsmart) found a creative solution and the the system is up and running again.  A million thanks go out to Raghu Ramaswamy, Chris Long, Robert Cooprider, Nita Surathu, Desi Grosso, Daryl Hall, Eric Hill, Chris Peak, Dave Gilbert, Janet Slawinski, Paula Mattingly for the creative technology solution and the Hospital leadership team; our pharmacy team (especially Brianna Englett) for their diligence in working out the emergency back-up process to ensure patient safety; and our nursing and medical staff for ensuring that patient safety was priority #1.

 

Arizona State Hospital In Good Standing

March 14th, 2014

Last September the Arizona State Hospital (ASH) was inspected (surveyed) for the Centers for Medicare and Medicaid Services (CMS). The survey team can review over 20 different areas and three were identified that we needed to address: Governing Body, Patient Rights, and Nursing Services.   In December, we developed and implemented a Plan of Correction which was submitted to CMS.  Some people think certification or licensure surveys are something to fear.  At the Arizona Department of Health Services (ADHS) and particularly at ASH we take a different approach.  Surveys are an opportunity.  They are part of the quality improvement process that health care facilities employ to make sure patients receive high quality care.  

A few weeks ago we had a return visit from CMS surveyors to verify whether we executed our Plan of Correction.   The entire team at ASH did a great job during the inspection- ensuring that the surveyors had everything that they needed to meet their objectives.  The required documentation was easy to find, and the surveyors got to see how well our team works together.  Today we received good news from CMS.  They’ve concluded that we’re satisfying their requirements, and that the Arizona State Hospital is in good standing, including our Deemed Status as a result of our Joint Commission Certification.  Congratulations Team ASH. 

Having external entities such as CMS and the Joint Commission (JC) review your organization creates an exceptional opportunity to get a fresh set of eyes on what a facility is providing for services.  If you think about it in the quality realm, the survey is an evaluation using evidence based practices.  Survey and accreditation standards are built to determine whether programs are delivering services in accordance with the accepted “Standards of Care” that have been developed from years of surveys, experience, research and best practice from regulators, clinicians, academics, legal analysis and patient experience.  Why would a program not want to have an opportunity to be evaluated according to these standards? 

So while some people look at surveys and their results as a negative reflection on the program we need to reframe that look from the lens of quality.  We want quality services and outcomes for patients.  Learning from both internal and external quality processes helps organizations meet those goals.  Continuous quality improvement only happens when you continually evaluate the services through the quality lens.  The team at ASH and ADHS is proud of the work that staff at every level are doing to meet the needs of some of Arizona’s most vulnerable citizens and fulfill our requirement of delivering high quality care. 

BTW: You can read more about some of our initiatives to improve the quality of care at the State Hospital here and here.

Please Help Supply Blessing Bags

February 20th, 2014

Patients and Staff at the Arizona State Hospital are working with the Phoenix Rescue Mission again this year to create Blessing Bags.  They’re large gallon sized Ziploc bags filled with basic necessities which will be handed out by the Phoenix Rescue Mission to the homeless.  But they need some donations to get going. 

The Hospital team has placed boxes to collect the items in various areas around the Hospital and in the lobby of our 150 Building. They need donations of: gallon size Ziploc bags, chap stick, packages of tissues, toothbrushes, mouthwash, shampoo (small sizes), combs, soap, band aids, hand-wipes, socks, gift cards for retail stores, trail mix, granola bars, crackers, and/or gum or mints. 

Anything on the list above that you can bring in over the next week or so will really help.  Take some time this weekend  to rifle through your bathroom drawers and make some room while helping out with this effort.  Of course, you could also take a trip through a Dollar Store and help stock that way too.

ASH Recheck

February 13th, 2014

Last week we had a visit from CMS (Medicare) to check on our plan of correction from a Survey that was conducted last fall at the Civil Units.  Although we won’t get a final report for a while…  we do know that Team ASH did a great job during the survey- ensuring that the surveyors had everything that they needed to meet their objectives.  The required documentation was easy to find, and the surveyors got to see how well our team works together.  

Good teamwork and professionalism all the way around.  Keep up the good work!

 

State Hospital Becoming a National Model

August 7th, 2013

Operating any type of medical or behavioral health facility is a balancing act.  It’s especially delicate at the Arizona State Hospital because we deal with patients who suffer from the most severe symptoms of mental illness.  Treatment practices at ASH has changed through the years to reflect contemporary approaches.  Decades ago, people with mental illness were heavily medicated and expected to stay in an institution for the rest of their lives.  Now we know that most mental illnesses are like other chronic diseases… and that with good medication management, therapy, and lifestyle changes, people can live healthy, productive lives.

Which brings me to the topic of the changes we made in the last couple of years at ASH to improve outcomes.    We converted from a 911-style response to an impending or active crisis to a system that uses more direct care staff who are all trained to help de-escalate the situation immediately.  It’s called Non-Violent Crisis Intervention.  As you might expect, we used evidence to drive our decision-making before we moved to this new model.   We researched the system before we changed and are tracking the results – and the results have been very good. 

In the first few months, we noticed a difference in patient outcomes – there were fewer times a crisis escalated into a major incident and when they did, fewer patients had to be restrained. That’s another benefit of having more direct patient care staff – teams build rapport with patients which helps prevent situations from escalating in the first place. It also provides teaching moments for patients.  Early in a developing situation, teams work with patients to help them understand the consequences before something happens – a principle of Recovery.

We’re now entering the 2nd full year of the Culture of Care and the response from patients and staff is encouraging.  Since it started, we’ve trained 748 staff on Non-Violent Crisis Intervention including on-going practice activities.  One of the ways that we track the success is the number of injuries to staff and patients.  Injuries happen in every business, so we focus on injuries that are tied to interactions with patients – everything from a push, shove or scratch to spitting or more serious injuries is counted. 

For example, the number of workers’ compensation claims we have from staff dropped from 311 in 2011 to 101 in the first six months of 2013.  That trends out to a one-third drop in claims… something any business would be proud to report.  Our increased and more robust effort to capture each incident- no matter how minor- means the raw number of reports are a little higher, but about 90% of the time when an incident report is generated, staff require no medical attention or simple first-aid like a Bandaid.  At the end of the day, safety is a priority at the hospital.  The Joint Commission  considers safety as part of the stringent review it does before accreditating a hospital; The Joint Commission accredited ASH in November of 2011.

As a result of our progress in establishing our Culture of Care, the Arizona State Hospital has been invited by the National Council of Behavioral Health to become a Trauma Informed Care Community.  I know that the transition to the evidence-based Non-Violent Crisis Intervention approach hasn’t been easy, and I really appreciate the work our excellent staff at ASH does for our patients and residents in their path to Recovery.  Well done.

ASH CEO Position

May 15th, 2013

Now that Cory Nelson has officially been appointed as our Deputy Director for Behavioral Health, we’re moving full steam ahead to recruit for the Chief Executive Officer of the Arizona State Hospital.  The CEO is a critical member of our team and has the responsibility of managing the day-to-day operations of the civil, forensic and sex offender units located on the campus.  This is a great opportunity for someone interested in being part of some of the most exciting changes happening at the hospital in years.  

Recently the hospital hit ten-month lows in the use of seclusion, restraint and patient falls… all as a result of new efforts that have been put in place to create culture change that engages patients and staff in the overall success of treatment.  The focus on Recovery, Trauma Informed Care using evidenced-based are all coming into full swing and present opportunities to even further improve the lives of patients on the campus.  Anyone interested in applying of for the position should submit an application through the State of AZ Jobs Site and look under the Department of Health in the agency section.

 

Blessing Bag Update

February 15th, 2013

I wanted to update on one of my December blog posts.  Around the holidays, patients at the Arizona State Hospital decided to take on a project – to help the homeless.   Patients wanted an opportunity to give back to the community in a way that would help those in need.  They chose a project working with the Phoenix Rescue Mission to create Blessing Bags to give to the homeless. Since many patients have been homeless in the past, they know what it’s like to have nothing. 

The patients collected donations for the Blessing Bags during the month of December. They collected travel size hygiene products, small snacks, gloves, socks etc.  Some patients even donated what they earned from the point store.  Then they filled gallon size plastic bags with donated items.  The patients also included a hand written inspirational note in each bag.  They ended up with more than 150 bags which will soon be distributed by the Rescue Mission.

 

New State Hospital Treatment Approach Leads to Improved Outcomes

February 12th, 2013

One priority at ADHS is helping patients on their path to Recovery at the State Hospital.  Our Hospital team cares for people who have mental health issues, whether for civil reasons or committed through the criminal courts.  We also oversee the Arizona Community Protection and Treatment Center.

Recent changes in security are making the Hospital a better place for patients, staff and the public. In the last four months – we’ve greatly reduced injuries to patients and staff – 23% for patient on patient assaults, 72% for patient on staff assaults; and we’ve reduced injuries by 83% for staff injuries from patient assaults, 26% for patient self injury. Why is this happening?

About a year ago, we began the transition to a new model with a cohesive team approach where direct care staff is fully engaging in all aspects of care.  This “Culture of Care” creates a better therapeutic environment for patients and residents to live and improve safety for everyone.  We’ve trained more than 700 staff on Non-Violent Crisis Intervention, an evidence-based, best practice for early intervention and de-escalation created by the Crisis Prevention Institute.  That’s allowed us to focus our staffing on direct patient care and overall hospital safety.  In the past few years, we’ve been able to maintain a good staff to patient/resident ratio by repurposing positions from administration and other supporting areas to areas that work directly with patients/residents on a daily basis.

The change has also helped us reduce seclusion and restraint, both major risk factors for psychiatric hospitals.   We’ve been able (under the new system) to dramatically reduce the number of injuries by 13% from 2011 to 2012… this year we’ve only had five… representing a 75% drop from the previous two years for the same time frame.  On the seclusion and restraint side, we’ve experienced an 80% reduction in just the last four months.  These are great changes that we expect to continue. 

Some other major changes to safety and security at the hospital in the last year include new scheduling to increase the number of staff available during high patient activity times, safer procedures when patients have to leave the hospital and revamping the way we review incidents with patients and staff.  The staff and leadership at the hospital have made tremendous strides to make it a better and safer place to work, live and reach recovery.  Nice job Team ASH!

 

Patients’ Drive to Help Homeless a Success

February 11th, 2013

I wanted to update on one of my December blog posts.  Around the holidays, patients at the Arizona State Hospital decided to take on a project – to help the homeless.   Patients wanted an opportunity to give back to the community in a way that would help those in need.  They chose a project working with the Phoenix Rescue Mission to create Blessing Bags to give to the homeless. Since many patients have been homeless in the past, they know what it’s like to have nothing.

The patients collected donations for the Blessing Bags during the month of December. They collected travel size hygiene products, small snacks, gloves, socks etc.  Some patients even donated what they earned from the point store.  Then they filled gallon size plastic bags with donated items.  The patients also included a hand written inspirational note in each bag.  They ended up with more than 150 bags which will soon be distributed by the Rescue Mission.

Behavioral Health Annual Report

January 10th, 2013

Our Behavioral Health Services team just finished and published our FY 12 Annual Report.  The new report identifies the number of clients served by service area, funding category and program; and includes programmatic financial reports of revenues, expenditures and administrative costs.  In it, you’ll see that we received a total of about $1.46B in funding for FY 2012 for behavioral health services.  Our Agency administrative costs were about 1% of the total (about $18M). 

The report shows our revenues and expenditures (including specific identification of administrative costs) for each behavioral health program category (The Seriously Mentally Ill; Alcohol and Drug Abuse; Severely Emotionally Handicapped Children; Domestic Violence; and the Arizona State Hospital).