Beth Israel Deaconess posts inspection report

Beth Israel Deaconess Medical Center has emerged from a week-long inspection with a list of items to fix but no systemic problems, the Boston hospital said today. The detailed report is posted on the hospital's website.

The Joint Commission, a national organization that since 2000 has conducted unannounced visits of hospitals it accredits, sent six surveyors through Beth Israel Deaconess last week. They examined the physical plant, read patient charts, and evaluated care at the hospital. They found 21 instances in which standards were not met -- eight of them classified as having "direct impact" on patients.

In one case of a direct deficiency, a patient who had complained of pain was not re-evaluated after medication was given, according to the chart pulled by the Joint Commission surveyor. The hospital has sent reminders to nurse managers emphasizing the need to document such assessments, Dr. Kenneth Sands, vice president of health care quality, said in an interview today.

“Our perspective on this list is that it’s important feedback,” he said. “They pointed out a number of things to us we thought are useful and important issues for us to address, but at the same time we don’t see a systemic pattern in this list of things. We don’t see that, for example, there is a pattern of lack of attention to facilities, ... or a pattern of not addressing patient safety.”

In another example of a deficiency, an eye-wash station near a sterilization center was blocked by rolling carts. In another, a surveyor found plastic bags in a bathroom trash bin near a spot where psychiatric patients were waiting in the emergency department, posing a potential risk for suicide. Both problems were corrected on the spot, Sands said.

Hospitals have an opportunity to respond to an inspection report, which is followed by accreditation unless there are problems that remain unresolved. The hospital must correct problems directly affecting patients within 45 days and has 60 days for others. Sands said this year’s report is similar to the last one, conducted in 2007.

Surveyors look at 250 to 300 standards, and each standard can have several subsections.

Sands noted that the report does not include praise Joint Commission surveyors offered in person about the hospital's “time-out” policy before surgery, when everyone involved takes a moment to check the accuracy of what they are about to do, and its communication with transplant patients about their therapy, medications, and care.