BANGOR, Maine — In recent weeks, leadership at The Acadia Hospital has come under fire, following confirmation of an ongoing investigation into working conditions at the psychiatric facility by the federal Occupational Safety and Health Administration.
At the end of last week, John Bragg, chairman of the hospital’s board of directors, said the board supports embattled CEO David Proffitt, despite a deluge of concerns raised by current and former employees and unflattering revelations about Proffitt’s educational credentials and his leadership at his previous post.
At its regular meeting last Wednesday, the board went into executive session to discuss the situation, Bragg said Friday.
“We came out supporting Dr. Proffitt and the changes that are in place and the team he has put together,” he said.
Acknowledging the apparent turmoil and erosion of morale at Acadia, Bragg said the facility is under stress from a number of directions, including changes in Medicaid reimbursement, changes in mental health treatment approaches and the transition in leadership when Proffitt took over at Acadia two years ago.
“There has been a lot of change there, no question,” Bragg said. “The board is in hopes that the dust will clear and the goodness of the hospital will shine through.”
Proffitt said Monday he is confident that employee morale will improve as a result of enhanced communications in recent weeks. A number of operational changes have been implemented already, he said, with more on tap.
The OSHA investigation was triggered earlier this summer by a complaint filed with the agency alleging an increase in patient assaults on staff after Proffitt implemented stricter standards against the use of mechanical and physical restraints, even when patients turn violent.
The policy is in keeping with national trends in mental health treatment that emphasize patient rights and the need to provide the least restrictive care possible. But Acadia employees say the policy has been enforced without providing sufficient training, support and staffing numbers, leaving nurses, technicians and other employ-ees vulnerable to patients who, as part of their illness, lose control of their behaviors and become violent.
Employees also have alleged that Proffitt has fired or pushed out a number of clinical leaders at Acadia, including former Vice President for Medical Affairs Dr. Paul Tisher and former Chief Nursing Officer April Giard. They have criticized his replacements as lacking expertise in psychiatric care. Proffitt’s own doctorate degree in health administration, granted in 2007 by the Warren National University, a now-defunct, online program that was never accredited, also has been criticized.
On Friday, Bragg acknowledged the uproar but said the board would not take action at this time.
“It would be a knee-jerk reaction if we were to get too overly excited about the articles in the paper and the comments that have followed,” he said.
Bragg said he is concerned about staff morale at the hospital and expressed optimism that the recent hiring of two new nurse-administrators, Vice President of Patient Services and Risk management Deborah Sanford and Chief Nursing Officer Karen Clements, will improve communications and employee relations at Acadia.
“There are many wonderful people who work there,” Bragg said. “And Acadia’s value to the community is great.”
Proffitt said a series of voluntary meetings with staff in recent weeks has resulted in some operational changes. More staff now carry emergency pagers, he said, and additional training in using hand-hold restraints has begun. In addition, more experienced staff is being assigned to units with challenging patients, psychiatric cov-erage has been expanded and a committee has been established to review all incidents of violence against employees.
Proffitt said he also has taken the opportunity to clarify his stance against the use of restraint in the acute care psychiatric setting.
“As a principle, I believe all occurrences of restraint are avoidable,” Proffitt wrote in a Sept. 10 memo to employees. “I also strongly believe that when a person is actively in a crisis and at risk for hurting themselves or others, restraint must be used and cannot be avoided. I hope that does not sound contradicting.”
On Monday, Proffitt said he expects these and other changes to have an effect on worker satisfaction at The Acadia Hospital. “Employee morale is a fluid thing in the best of circumstances,” he said. “I think it is improving [at Acadia] as communication is improving.”
OSHA investigators continue to examine reports of patient assaults on staff at the hospital.