DHHS joins Acadia worker-safety investigation

By Meg Haskell, BDN Staff
Posted Aug. 24, 2010, at 9:25 p.m.

BANGOR, Maine — The State Department of Health and Human Services will investigate conditions at The Acadia Hospital, after reports of a federal investigation into worker safety at the 100-bed psychiatric facility.

Anne Flanagan of the DHHS Division of Licensing and Regulatory Services said Tuesday that a team of inspectors will visit the hospital sometime within the next few weeks.

“Our primary concern is what happens to the patients who go to that facility,” she said. But employee complaints of an increase in the number and severity of injuries suffered when out-of-control patients become assaultive raise concerns for patients and employees alike, Flanagan said.

The Occupational Health and Safety Administration confirmed Monday that the federal agency has been conducting an investigation at the hospital since the end of last month, after receiving a formal complaint from an employee whose identity has not been revealed.

Acadia Hospital nurse Katie Gardner said she is not the employee who lodged the complaint. However, in an interview with the Bangor Daily News on Monday, she said new policies prohibiting the use of restraints have left nurses, technicians and other direct-care workers vulnerable to patient attacks. Gardner said the policies were adopted without adequate staff preparation and training.

Acadia officials acknowledged the investigation and the nature of the complaints and said the hospital administration is cooperating fully.

In an interview Tuesday evening, Acadia CEO David Proffitt said there is a national agenda to end the use of all “coercion” in psychiatric settings. That includes seclusion, which he said has not been in use at Acadia for several years.

Mechanical restraints, including straps and vests used to prevent patients from hurting themselves or others, were discontinued over a year ago, he said. Only physical restraints — hands-on techniques used to subdue and calm out-of-control patients — are still in use at Acadia, he said. And despite the furor over limiting even these techniques, Proffitt said it remains his goal to do so.

But some of Proffitt’s goals — and how they have been implemented — have come under fire from past and present employees.

On Tuesday, Dr. Don Payne of Holden, a psychiatrist who practiced for more than 10 years at Acadia before retiring in 2009, faulted Proffitt’s leadership style for undermining employee safety and morale. The restraints issue, Payne said, is typical.

“The Acadia staff was very well-trained. They had been working forever to reduce the use of restraints,” he said in a telephone conversation. “Proffitt got rid of restraints overnight with minimal preparation of the staff, and it was just chaos.”

Proffitt assumed leadership at Acadia in 2008 after a four-year tenure at the state-run Riverview Psychiatric Center in Augusta.

Payne said changes at the hospital since Proffitt took over have resulted in the loss of several key clinicians and increased reliance on doctors who work for temporary placement agencies.

Proffitt said the use of temporary doctors has decreased and that Acadia has recently hired “six or seven” new psychiatrists.

Proffitt also said he recognizes that care providers feel more vulnerable when they cannot physically restrain a dangerous patient. But in fact, he said, “the most dangerous thing we do is ask our staff to put their hands on someone who is out of control.”

He said the number of time-lost injuries due to patient assaults has decreased along with the reduction in the use of restraints, although a few workers have been seriously injured.

Proffitt said he hopes the OSHA investigation will reveal useful insights for protecting the safety of Acadia employees while enhancing patient care.

“No one should come to work and get hurt, and we should provide a coercion-free treatment experience for our patients,” he said. The two goals are not mutually exclusive, he said.

John Bragg, president of The Acadia Hospital board of trustees, said Tuesday the board had not been apprised of the OSHA investigation. But board members were well-acquainted with and supportive of Proffitt’s goal of doing away with the use of restraints at the hospital, he said. Bragg, who is vacationing in Virginia this week, said he may convene a meeting of the board’s executive committee to discuss the state and federal investigations at Acadia in advance of the next full board meeting Sept. 22.

The Acadia Hospital is an affiliate of Brewer-based Eastern Maine Healthcare Systems. It has 600 employees and is licensed for 100 inpatient psychiatric beds and also provides outpatient psychiatric and substance abuse services.

http://bangordailynews.com/2010/08/24/health/dhhs-joins-acadia-workersafety-investigation/ printed on December 20, 2014