State to pay for review of Oregon State Hospital

From the Salem Statesman Journal, June 26, 2010

$175,000 contract aims to help improve mental health care

A section recently demolished of the Oregon State Hospital

A section recently demolished of the Oregon State Hospital

The state has hired a Pennsylvania-based firm to conduct a $175,000 “quality and compliance” review aimed at improving patient care at Oregon State Hospital.

Liberty Healthcare’s looming review of the Salem psychiatric facility follows a series of investigations that found flaws and failings in patient care.

The outside review is designed to “bring a fresh and expert perspective to this complex operation,” according to the firm’s contract with the state.

The Statesman Journal obtained a copy of the contract through a public records request with the state Addictions and Mental Health Division.

READ – Liberty Health Care Corporation contract to review Oregon State Hospital

Confirmed neglect of a patient who died at the hospital last autumn prompted officials to seek the external review, said Richard Harris, director of the Addictions and Mental Health Division.

“Patient care issues are really looming (as) the largest of all the challenges we have in the hospital,” he said. “The sort of question is: How would you make sure that people were doing their jobs the way they needed to do them?”

In an e-mail sent to members of the OSH advisory board, interim hospital superintendent Nena Strickland said Liberty Healthcare has more than 20 years of experience in providing an array of quality improvement programming, specialty consultations and training.

“While these are difficult economic times, we firmly believe this one time investment will improve the future of patient and staff safety,” she said.

Liberty’s corporate headquarters are in suburban Philadelphia, according to the company Web site. The firm also has offices in California and Indiana.

Harris said the consulting firm will send a team of specialists to visit the state hospital July 12-15. A second visit is yet to be scheduled.

“The expert team shall advise OSH as to what works and what does not, and focus on where patient care is delivered on a day-to-day basis,” states the contract. “The review shall focus more on what actually happens on the units versus how the reports and minutes look.”

The consultants are scheduled to issue a draft report by mid-August and a final report by the end of September.

Though the state hospital has a quality-improvement unit, Harris said that an outside review was deemed essential by Human Services Director Bruce Goldberg and himself.

“My belief is we’re not at the proper level with that (internal) quality-improvement program, and I want an outside entity to tell us what we need to do to change it and make it more effective,” Harris said.

Liberty Healthcare’s specialists will meet with a large number of hospital employees, according to the contract.

“It is estimated that there are over 100 key management and line staff members that Contractor will want to interact with directly, either individually or in groups,” it says.

After completing their review, the consultants will “create a blueprint for action,” the contract says.

The new consulting contract comes at a time when state agency budgets are being cut by 9 percent to plug a $577 million shortfall caused by a drop in tax receipts amid the recession.

“It is difficult to find $175,000 in the hospital budget, but to me if we don’t do this we are jeopardizing the primary mission of the hospital and certainly my concern about improving patient care,” Harris said. “So I think it is an investment that will pay off in the future.”

Money for the consulting work will come out of “administrative costs and savings,” he said.

Harris and Strickland emphasized that funds used for the consulting work will not cut into the hospital’s ability to hire more front-line staffers this summer.

The quality of patient care at Oregon’s main mental hospital has been called into question by multiple investigations.

State officials recently capped the latest investigation by revealing that five hospital employees had been reprimanded for lapses in care provided to Moises Perez, the patient who died last fall.

Perez, 42, was found dead in his hospital bed Oct. 17. An autopsy determined he died of coronary artery disease.

In February, the U.S. Department of Justice sent a letter to the state saying that its review of Perez’s treatment found “alarming” failures.

Breakdowns in the patient’s care mirrored problems federal investigators reported to the state two years ago, wrote Shanetta Cutlar, chief of the Special Litigation Section of the U.S. DOJ’s Civil Rights Division.

Cutlar’s letter called for the state to take immediate action to improve patient care and protect their safety.

A separate state investigation into Perez’s care, conducted by the State Office of Investigations and Training, determined the hospital neglected Perez by failing to provide adequate medical care.

The OIT investigation triggered a shakeup in hospital leadership. Superintendent Roy Orr was forced to resign on April 2, the same day the state released results of the OIT investigation.

The state is moving forward with a search to hire a new superintendent. Last week, the field of candidates was narrowed to six from a pool of more than 30 applicants.

Harris said he hopes to fill the job by the end of July.

“I’m quite optimistic that from this pool we should be able to find somebody that should do a good job,” he said.

State officials are not releasing the names of the six candidates.

“I think that’s probably pretty much normal in a job search for a high-profile position like this,” Harris said.