Monday, July 20, 2009

OSF's Keith Steffen and the "Corridors of Shame"


During my blogging the last couple of years, I have documented a number of serious reasons I thought Keith Steffen should be fired from OSF.

His actions regarding Haitian Hearts is deadly, OSF's EMS monopoly is deadly, and the overcrowding in the OSF-Emergency Department is deadly.

I don't think OSF will fire Keith because they would have to admit that they supported him for so long and paid him quite well as OSF's administrator. And it would expose many others at OSF that are telling Keith what to do and how to make more money for this very large and powerful Catholic medical center.

The reason I wrote Keith in 2001 regarded my concerns of the overcrowding and dangerous work conditions in the OSF-Emergency Department.

While I was speaking with Keith in his office for the first time after I wrote him, he likened me to a malignancy that needed to be "cut out". I was surprised to say the least.

David Newman, M.D. is an ED physician and writer. He recently wrote about the huge number of people that were flooding the ER's in New York City this year due to Swine Flu fear.

Dr. Newman writes:

"The impact is clear: lives were lost. High quality studies have shown repeatedly that when ED's experience crowding patients in need of rapid, high intensity care are identified later, treated nore slowly, and devoted fewer resources.

Mortality goes up during crowding in virtually every condition that has been studied, including MI, sepsis, and others. The irony is stark: Once a critical mass is reached, the more that come to be saved, the fewer we can save."

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A brief Emergency medical abstract that I recently read stated the following:

"ED overcrowding is a steadily increasing patient safety hazard. Practical solutions to ED overcrowding are rare, but the United Kingdom has mandated a 4-hour ED stay rule since 2005 whereby 98% of patients must be in and out of the department within this brief time period. Strict adherence to this rule requires buy-in from hospital board members, senior administrators and departmental leaders.

"...themes to implement and sustain successful change included diagnostic testing ordered upon patient arrival, senior decision makers involved early in the care cycle, clincial decision units, and hospital leadership responsive to ensuring timely inpatient bed availability.

"TURNING POINTS TO SUCCESS WERE ONE OF TWO EVENTS: CHANGE IN HOSPITAL LEADERSHIP OR EFFECTIVE CHIEF EXECUTIVE RESPONSE TO A CRISIS."

OSF doesn't have the courage to admit their mistakes. They won't get rid of Keith Steffen.

Too bad for Peoria.

1 comment:

Undercover OSF said...

Doc,
Are you familiar with OSF ER's new triage system? They put patients in a line like they are at a movie theater. Only one person is allowed at triage, allegedly due to HIPPA. The rest sit and wait (and wait, and wait...). Everyone can hear what is going on, so there are is no real protection against privacy violations. HIPPA is being used as a convenient excuse.

In my opinion, this change was enacted because triage personnel find it inconvenient to be surrounded by incoming patients while working. Fair enough, but maybe instead of lining people up, OSF needs to re-assess the staffing at triage.

One of these days, in their haste to get people into a nice, neat little line, someone is going to miss a key sign or symptom. And then someone is going to die right there at triage, all because triage staff could not be bothered to ask a couple questions.