Monday December 3, 2007
Subcommittees Starting to Submit Draft Recommendations to DPC Task Force
Wilmington – The leaders of two Delaware Psychiatric Center (DPC) Task Force subcommittees have submitted draft recommendations to the co-chairs of the nine member body that is looking at opportunities for improvement at the DPC. The Task Force, created by Governor Ruth Ann Minner in August, is due to make its final recommendations to her by December 15th.
Subcommittee 4, charged with reviewing the need for a new DPC facility met Monday morning at the Dept. of Health and Social Service’s Holloway Campus and reviewed the draft prepared by team leader Dr. Gary Wirt.
The group’s top recommendation was to move forward with the construction plans for a new DPC facility. With that, it also recommended that a more detailed, independent actuarial study be conducted to determine the most appropriate size and number of beds for the hospital. Members cautioned Renata Henry, Director of the Division of Substance Abuse and Mental Health (DSAMH), that there was no clear evidence on how the Division arrived at the proposed number of 205 beds for the new facility. They said providing that information would help the Division make its case for a new facility at budget time.
An independent review of each patient at DPC was also recommended to determine who should remain at the facility or identify what additional support would be needed to relocate patients to community based alternatives. In its draft, the group further urged “the expansion of community resources that serve as less costly and more effective alternatives to institutional care. The State must not continue to spend disproportionately on institutional care at the expense of community alternatives.”
The results of such a patient by patient review could impact the ultimate size of the hospital as could the results of a more detailed projection for the psychiatric needs of the growing geriatric population that the subcommittee recommended. Team members encouraged Henry to investigate the inpatient needs of this group of individuals keeping in mind that the greatest potential for growth in the aging population would likely be in Sussex County and not New Castle.
The subcommittee’s draft also called for further analysis of cost factors and additional investigation of various pricing options for a new facility, noting that the determined cost per bed for patients seemed high compared to other state hospitals. If however, the appropriate size could be determined and substantiated, the group recommended moving forward with construction as quickly as possible in an effort to realize hundreds of thousands of dollars in anticipated savings by offsetting the current maintenance costs which are draining the Division’s budget.
Finally the draft by Subcommitee 4 emphasized that “a hospital is more than new walls and (the subcommittee) stresses the need for additional staff training, especially in psychosocial rehabilitation and recovery.”
Similar statements were echoed in Subcommittee 1’s list of recommendations which were presented at their Friday November 30th meeting. The group, lead by Dr. Harold Rosen, provided a list of eight recommendations for consideration.
Among them was the importance of staff recruitment, retention and training. The recommendations stated that key hospital leadership positions must be filled with skilled professionals, and that there must be a clearly identified leader in each unit empowered to make decisions. Furthermore, adverse events must become opportunities to learn, and not just opportunities to assign blame.
Acting DPC Director Guy Perotti said the agency is making strides to show staff that the Performance Improvement Unit is not a way to criticize people but a way to improve upon what they are doing.
The top recommendation from this group was that a Performance Oversight Committee be formed to oversee the quality and safety of patient care, strategic planning and management performance. Group members believe the Oversight Committee should include a mix of DHSS senior leaders and community members with experience in health care, advocacy, and management.
Other recommendations focused on expanding the role of physician leadership in the Performance Improvement Process, and being open to the possibility that the Hospital Director could be a physician. Finally, the group recommended providing DSAMH with additional resources to provide high quality community based treatment for the chronically mentally ill.
That was a theme repeated in Subcommittee 3’s meeting that same afternoon. The group which is reviewing additional opportunities for community placement of patients did not present its draft recommendations. Instead it heard from Renata Henry about the process for patient discharge to the community who said that the greatest barrier to discharging patients was a lack of community housing.
Community providers who testified at the meeting urged subcommittee 3 to recommend rapid expansion and enhancement of new and existing community based programs again noting that community based care is cheaper than institution based care. They also said that adequate funding should be provided to maintain the needs of persons discharged into the community. Finally they suggested a transition plan be created and an outside monitoring group oversee its implementation and provide follow up.
Members of the public are encouraged to continue checking the DPC Task Force website for updates on the scheduling of the Task Force’s final meeting. Draft recommendations from all four subcommittees will be reviewed and discussed at that time and voted on for adoption. The website is available at www.dpctaskforce.delaware.gov. |
