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Friday, August 10, 2007

Beth Israel Deaconess posts inspection results

By Liz Kowalczyk, Globe Staff

Following the lead of Boston's other large teaching hospitals, Beth Israel Deaconess Medical Center today released results of its inspection by a national oversight organization -- results usually kept secret by hospitals across the US.

Beth Israel Deaconess posted on its website its report from the Joint Commission, which has told the hospital to improve in nine areas.

In the past few months, five academic medical centers in Boston have released their results, and several said more problems were found than in the past under a revised inspection system. The Joint Commission, based in Illinois and the country's primary inspector of hospitals, now conducts surprise visits, rather than telling hospitals weeks in advance when inspectors will arrive.

This year, the commission issued Massachusetts General Hospital 10 requirements for improvement; Brigham and Women's Hospital, nine, Dana-Farber Cancer Institute, which does not have overnight patients, three; and Children's Hospital Boston, three. Boston Medical Center initially received eight requirements for improvement but disputed two.

At Beth Israel Deaconess, inspectors found several instances of nurses or doctors failing to ask patients to list their medications, or to otherwise update patients' medication lists. In at least two cases, doctors did not update the electronic list of patients' medications, creating discrepancies between computer and paper records. In another case, a patient was transferred to another hospital without a complete list of medications.

Updating medication records is done to ensure patients are not given drugs or treatments that could cause dangerous reactions, or to "reconcile" their medications as they are transferred or discharged. Massachusetts General and Brigham and Women's hospitals and Boston Medical Center all were cited for this shortcoming.

In five other instances at Beth Israel Deaconess, nurses or doctors did not properly assess patients' pain levels, or record them in their medical records. This is important partly so caregivers can determine whether a treatment is working to improve a patient's pain.

Hospital President Paul Levy said in a letter to staff today that doctors now will be required to use the electronic medication reconciliation system.

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