June 26, 2018
Episcopal Campus, Room 213
In attendance: Betsy Nulty, Gary Peoples, Sue Clements, Richelle Kozak, Yasser El-Khatib and Jeanine Penn
- Building is now managed by Common Wealth Health
- There is on campus a 126 bed drug and alcohol detox, rehab: Can CRC refer patients to this unit?
- Episcopal rents space for Chemo, Endo, imaging, Ready care, administrative space
- Special Smiles has also re-located to NE.
Review outstanding issues
- ProV policy will be finalized on 6/27 with Luanne and Steve Buckley and forwarded to the union.
- Discharges from CRC remain problematic with high risk for patients and staff.
- Yasser is open to suggestions as ProV will not be available when present devices become non-functional.
- Higher level of security, e.g. handcuffs, would require additional training for all security officers
- Fox Chase and Jeanes have their own security force, but face the same problems
- Police use the campus at times for preplanned events. Episcopal has not agreed nor disagreed with their presence, but wants to maintain good relationships with the surrounding districts.
- Security is, at times, requiring staff to escort visitors from the lobby to patient’s room when there are visitor restrictions. Since security has names of visitors who are permitted, why is this necessary?
- Age restriction for Behavioral Health visitors is eighteen. Babies and small children are not permitted on behavioral units. Security needs to be aware.
- C6 patients are allowed visitors 24/7 per CMS regulations. Service animals are also allowed
- Management recommends discretion in allowing some visitors to stay overnight that must include good documentation for refusal. (risk of drug use, etc)
- Case managers are sometimes prevented by security from coming to CRC
- Fire Rescue continues to bring patients to the ER when they are on divert causing dangerous overcrowding conditions.
- Eight instances in the past month. See attached list.
- Yasser will look into the issue
Medication Bar Codes
- Many medication Bar Codes are not scanning in the ER.
- Message sent to pharmacy via Epic have not resolved the problem
- C6 has also experienced the problem to a lesser degree
- Yasser will address to pharmacy director
- Staff should continue to communicate failure to scan through Epic
Inpatient Behavioral Health Issues
- Knife and box cutter brought on unit by visitor. Midas was filed.
- Direct admission to inpatient procedure not followed. Transporter brought patient directly to the unit. Process should be entry through the ER, escorted by security to CRC for scanning and registration, then escort to unit by security.
- Visitor with a baby brought to inpatient unit, but was not admitted to the unit.
- Yasser will address issues to Luann/security.
Impact of opiod crisis on CRC and ER
- What is the City doing to mitigate the influx of overdose patients/overcrowding in the CRC and ER?
- Overdose patient are in ER be 6 to 10 hours holding up as many as 5 beds at a time making it impossible to find a bed for an acutely sick patient
- Safe injection sites—community is 60/40 in favor of sites
- City is still looking at locations. Funding is an issue
- Episcopal will not run any of the programs, but we will rent space.
- Project Home/Sister Mary Scullion is in talks with Episcopal about using the School of Nursing for residences for homeless. Plan is being presented at a Community Town Meeting.
- Population Health is offering MAT (medically assisted treatment) with suboxone, detox and rehab
- Dorazio is leading MAT program on our campus
- Challenge of misinformation. Vivitrol reportedly has had good results, but rumor on the street is that it will kill you
Placement of patient from the CRC
- Treatment facilities are causing delay in moving patients. Information faxed at 8:30am, review of information already sent to the facility at 12pm. Call back at 2pm accepting the patient.
- Episcopal is held accountable by CBH for patient complaints over delays, patient leaving before they can be placed. Can’t CBH facilities for more reasonable time frame for accepting patients?
- Per Yasser, CBH can’t push the facility rules
- Eric meets with CBH regularly at directors meeting
- Consider re-establishing relationships with treatment facilities. Invite representative to the CRC.
TUH Record of Supervision Meetings
- New form to address NIAC request for supervisory notes during CBH survey
- Not disciplinary. Would be used to document discussions with staff
Window for Joint Commission Survey
- Restraint documentation is crucial
- Suicide assessment on Rooms on C6
Restructuring of TUHS
- Plan is to sell off Jeanes and Fox Chase. We presently send 30-40 patients a month to Jeanes.
- There has been no word on plans for Episcopal. We are trying to be preemptive and proactive