A Long Strange Week

It seems that that the current Washington State Governor and his appointed Western State Hospital and DSHS Administrations have reached a new apex of incompetence.  By the CEO eliminating competent personnel in key positions and replacing them with his own incompetent selections and personal friends (rather than hiring panel recommendations), Western State Hospital has collapsed internally and WILL most likely lose $65 million in Federal Funding because the current Governor did NOTHING to intervene or replace the problem.

Since the current CEO was the first CEO to ever be hired to a multiyear contract, WSH has reached the lowest point I have observed in my 31 year history at WSH.  Certain individuals were KEY to keeping WSH productive and accountable…  Most were eliminated by the CEO.  The CEO had eliminated the Medical Director for an extended period until he was FORCED to replace the position…  Again and again…  The CEO is now trying to eliminate the Chief of Staff position (an elected position).  This CEO does not listen to committee recommendations and has taken steps to assure that care providers and patients remain working in dangerous conditions where less restrictive measures remain unavailable.  There can be no culture of safety at WSH while this CEO and Administration remain.  When the CEO is present at a meeting, we know that any presentation that is made would be pointless, as his fixed points of view never waver though presentation of facts or reason (but we carry on anyway with the presentations).  This is consistent with the fact that the CEO has never to my knowledge hired any key administrative employee that was recommended by a hiring panel consensus.  Note that DSHS and Olympia do not allow the CEO to speak to the media so as to let his brilliance shine (for all to see).  

This week has been difficult to observe…  I can remark about some of the data because it has already been reported in the media…  The following occurred over the past week:

  • One extremely dangerous patient escaped by opening a window, walking fifty yards to the bus stop.
  • Two additional patients with criminal histories also escaped.
  • A patient was found dead on another ward on the same day, I do not know about the medical examiner results.
  • A patient was allegedly raped in HMH within the past week.
  • A staff member on a “two staff to one patient” assignment was beaten up and hospitalized within the past week.
  • On East Campus the heating system one morning switched to FULL ON heating and could not be controlled, sending the temperatures in many rooms to close to 100 degrees unit wide…  The troubleshooter had to wait for day shift maintenance to come in and figure out what was going on…  The heat was so severe that items melted and an electrical fire could have erupted at any time.  Literally nobody knew what to do.  Exit doors had to be propped open in non-secure areas and ward patio (secure area) doors had to be propped open on all wards.  
  • The flu continues to circulate within the hospital due to the Medical Director keeping the initial flu outbreak top secret.  I will report on this issue later.  The spread continues…  
  • Employee survey results indicate that since implementation of the current CEO, the hospital has fallen on its face and may be unrecoverable with regard to safety and morale.  See blog entry.
  • The Joint Nurse Staffing Committee was told that if the funded 51 Registered Nurse positions are not filled by July, the funding will return to Olympia.  This would be tough to do as RN’s are now 25% behind in pay with the public sector and WSH is about to lose CMS funding through administrative incompetence.  The very first action of the CEO was to eliminate an RN position, even though he was briefed of the SEVERE RN shortage at WSH.  I look forward to publishing the meeting minutes of the Joint Nurse Staffing Committee meeting.
  • The WSH Security Department Head created its own escort procedures resulting in myself having to file complaints with the Department of Health to assure that the Security Department was mandated to escort patients to criminal arraignment hearings and criminal court proceedings… The Security Manager wanted UNTRAINED nursing personnel to perform the transport/escort task (instead of security) using caged cars that nursing personnel were never trained to use.   Administrative appointed nurse managers were going to go along with this nonsense before they were stopped by the open complaint filing.  Something like this could have never happened in any other CEO administration.  It was kind of a prophetic situation due to the civil patient escapes. 
  • Staffing has consistently been insufficient, resulting in frequent mandatory overtime.  Records will indicate that minimum base safe staffing could not be provided daily due to the MASSIVE staffing shortage that the CEO denies exists.  We have all noted that staffing is DRASTICALLY better when CMS and Joint Commission inspectors are present.  A note to CMS and TJC surveyors…  PLEASE COME AND STAY!!!

I was surprised to learn that C4, the ward where criminal past civil patients (HB 1114 patients) were assigned, was NOT considered an acute care ward by WSH administration.  I checked into the Central Safety Committee and Central Campus Safety Subcommittee (meeting minutes) records to determine why acute status was not applied to that ward.  Monthly meetings are required by the Safety Committee Charter.  I came to find that zero meetings or minutes were filed for the Central Campus Safety Subcommittee since February of 2015…  Meaning that C4 was not vetted by its own Safety Subcommittee.  This violates accreditation requirements at every level.  The Safety Committee Charter can be found here. 

Facts speak for themselves…  The buck stops with the Governor who took no action to change a dysfunctional and incompetent administration at Western State Hospital and DSHS.  WSH will most likely lose $65 million in federal funding on May 3, 2016…  Unless we continue to receive (what seems to be) endless short term extensions during an election year.  

But since this IS an election year, all of us can exert influence over a change in leadership through the election process.  A drastic change needs to occur to improve mental health care.  BE SURE TO VOTE!  


Your two choices for Governor will be:

© Paul Vilja 2017