One Thing Leads to Another
In September 2001, patients in the ED at OSF-Saint Francis Medical Center were waiting too long to be seen and then if they needed to be admitted, were waiting too long in the ED before admission.
The ED staff was seeing thousands more patients than the ED was built to see. The ED staff was unhappy as evidenced by the survey which showed the least employee satisfaction of any department in the medical center. And the ED patient satisfaction scores were the lowest of any department, also.
I had spoken to Rick Miller, the Director of the ED, a couple of times in the previous few years voicing my concerns over the dysfunction of the Department. But he gave me no satisfaction that he was able to change the Department for the better. In 2001, Miller was pushed out and was replaced by George Hevesy as Emergency Department head.
On September 27, 2001, I wrote an email to Keith Steffen, who was administrator at OSF. I copied my ED colleagues on the email.
The ED secretary who typed the email for me told me that I would "likely get fired" if I sent the email.
Here is the email--
September 27, 2001
Keith Steffen, Administrator
OSF Saint Francis Medical Center
Peoria, Illinois 61637
Dear Keith:
I started working at OSF-SFMC in 1971 as an orderly on 8B. Most of my last 30 years have been spent inside this building. OSF-SFMC means everything to me. Please interpret the following knowing my heart and spirit are with St. Francis and always will be.
I worked 3-11 last night in the main ER. The ER mayhem and disarray that usually exists was actually somewhat manageable. However, patient-waiting time from disposition to arrival on the floor was unbearable. Two sick patients of mine, rather than staying in the ER all night, politely decided to sign out, go home, and hope for the best.
Giving appropriate care in the ER can be challenging but having no room upstairs to admit the patient can be life threatening to the patient. Should I call other medical centers around the area/state for their admission and subsequent care before I see the patient or after? Studies have shown increasing time spent in the ER increases patient morbidity. Obviously, I don't want to do this. Please tell me what to do.
An ER crisis has been occurring for many years in our ER. But last night with "home diversion" of patients we have reached an all time low. This cannot continue.
I need an immediate answer from you today as to how I should approach these sick patients and their families. I will meet with you any time today or tonight.
My pager is always on (679-1980.)
Sincerely,
John A. Carroll, MD
cc: Sue Wozniak, Chief Operating Officer
Tim Miller, MD, Director of Medical Affairs
Susan Ehlers, Assistant Administrator Patient Care Delivery Systems
Paul Kramer, Executive Director of Children's Hospital of Illinois .
Lynn Gillespie, Assistant Administrator Organizational Development
Emergency Department Attendings
----
I did not hear back from Keith but did hear the next day from Dr. George Hevesy who had been promoted to ER director on August 1 to replace Dr. Rick Miller. His secretary handed me his letter to me as I was starting to resuscitate a man in the ER who had a cardiac arrest and was brought in by ambulance.
George put me on probation for 6 months. He also stated that starting in November, I would only work in OSF Prompt Care. Hevesy did not disagree with the content of my letter but told me that I had gone around normal communication channels and that I would be suspended from the ED for 6 months.
After I read the letter, I called George at OSF’s new Center for Health where he was working and asked him if he was really serious about what he had written. He said that he was and for me to stop in and see him sometime so we could talk.
Over the next few months I had conversations with George. He stated that for me to come off "probation", I needed to be seen by the "wellness committee" for "burnout". I told him that he was sacrificing the messenger for the message.
At a previous department meeting George had referred to all of us as "crispy critters" due to the stress of working in the dysfunctional OSF-SFMC ED. During the next few months, October, November, and December 2001, I worked all of the shifts in Prompt Care I was assigned to and continued taking care of my Haitian Hearts patients at OSF. Also, during these months I had discussions with Keith Steffen up in Administration regarding my probationary status in the ED.
----
Comments in 2021--
- I thought in 2001, that George Hevesy and Rick Miller, were compromised leaders of the Emergency Department and beholding to Administration at OSF. They had been in charge of the Emergency Department for the previous decade and the ED was very dysfunctional. But it was not solely the fault of the ED that patients were waiting a long time to be admitted. It was a systemic hospital wide problem that needed to be studied and corrected in a logical fashion.
- As the months went by at the end of 2001, I began to see how OSF's problems were serious and started on top and trickled down to the different departments.
- I began writing a blog in 2006, which I called Peoria's Medical Mafia. In the blog (and the blogs which followed), I attempted to show how big guys at the top, both in Haiti and in Peoria support each other and negatively influence Haitian lives, the Emergency Department at OSF-Saint Francis Medical Center, and Emergency Medical Services in Peoria.
- And I document how people the public usually trust can be involved in serious conflict of interest with negative consequences for everyone.
- In my blogs I also write about what happens to medical whistleblowers behind the scenes.
- Looking back the past 20 years, I spent too much time documenting on my blog sites. In other words, how often did I need to site experts as they explained why Emergency Department Crowding was a "hospital wide problem" that needed a "hospital wide solution?"
- And how often did I need to illustrate how the lack of infrastructure in Haiti causes Haitian kids to become sick and die?
Comments
Post a Comment