Update on Security Improvements at San Francisco General Hospital Department Public Health Health Commission Meeting December 17, 2013 1
New Security Measures Implemented Beginning in October Daily emergency stairwell checks by Sheriff deputies All emergency stairwell door alarms converted to continuous alarm requiring deactivation with a key When a stairwell alarm rings, it triggers a security check by Sheriff Deputies When a stairwell alarm rings and the stairwell is near a patient care unit, the charge nurse immediately checks the unit to ensure that all patients are accounted for SFSD leadership meeting weekly with SFGH CEO 2
Investigations SFSD conducted an investigation and released preliminary findings on November 6. CA Department of Public Health conducted an investigation on behalf of the Centers for Medicare and Medicaid Services from October 30 to November 8. An unannounced CMS validation survey with a full team of investigators will occur to verify the implementation of a comprehensive plan of correction. On December 9, submitted a Plan of Correction to the Joint Commission, an independent agency that accredits hospitals, on the sentinel event death of Ms. Spalding 3
Third Party Independent Review DPH has contracted with UCSF to perform a systems review and risk assessment Specific tasks (to be completed by February 2014) include: UCSF will contract with a third party vendor to review SFGH security system controls (e.g. cameras, alarms, panic buttons) Peter Balestrieri and the UC Police Chief Pamela Roskowski are starting to conduct interviews that will inform the review by identifying staff needs and priorities, experiences with the implementation of security policies and suggestions for improving security Review of policies and procedures related to patient, staff and visitor safety and security Review and assessment of current SFGH Campus security resources (staffing model, hours of service, post and patrol areas covered, job duties, training, and job classifications assigned) Recommendations already made include: SFGH and SFSD should join the International Organization of Healthcare Security and Safety, a membership forum with resources for Joint Commission and other regulatory best practices and policies - done Revise hospital Security Management Plan – in process 4
SFSD Changes Staffing and Chain of Command Changes Captain Kenneth Ferrigno has been assigned to the SFGH campus full time as the Institutional Police Unit (IPU) Unit Commander. He reports directly to the Sheriff Two full time Lieutenants have been assigned to act as SFGH Site Commanders Training A full time SFSD Training Officer has been assigned to the SFGH campus All 46 SFSD staff assigned to SFGH have completed SFGH new employee orientation and training, including SMART training The SFSD is developing six week training course specific to working at DPH sites Staff Communication Space has been provided at the hospital so that at each shift change (3 times a day, 24/ 7) the SFSD watch commander conducts a muster meeting – where information regarding current security issues in the hospital is passed along from shift to shift so there is continuity of services SFSD Policy and Procedures relevant to the Institutional Police Unit operations at SFGH are being reviewed and revised 5
CMS Key Findings and SFSD Corrective Action Plan (CAP) CMS Key Finding CAP I tem Lack of oversight of contract Update MOU to include and performance metrics performance metrics, training requirements, and compliance Insufficient policies & with hospital policies, procedures, including policy procedures and regulations formulation and approval process, establishment of Revision of Security performance measures, and Management Plan (Joint overall compliance Commission required) Inadequate communication Monthly meetings between center systems and Sheriff and Director of Health procedures Insufficient DPH involvement in SFSD staffing at SFGH 6
Communications Critical Incident Response Teams have worked with several units affected by the tragedy and are still available to counsel individuals and groups The Sojourn Chaplaincy held a service of healing for staff on Nov 7. Chaplains are available to counsel individuals. A Staff Town Hall was held on Nov 1. A discussion of this tragedy at Management Forum on Oct 22, with CEO Sue Currin, CMO Todd May, Director Barbara Garcia and Sheriff Ross Mirkarimi 7
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