State of WSH Propaganda & PERT

PERT

                                            Special thanks to the local genius that created the above graphic!  


Recently WSH apparently suppressed information regarding the Psychiatric Emergency Response Team (PERT) to not only the our WSH personnel, but also to the Legislature to provide eight million dollars plus in funding for expansion of PERT in lieu of funding much needed (and required) permanent staffing positions to null out overtime usage.  


PERT was originally intended to enhance ward staffing by allowing PERT members to do ward rounds and do nothing other than interact with patients in order to meet their needs to prevent escalations and assault situations from occurring.  Instead what was initiated was a “CEO driven police force” that was given their own uniforms so as to differentiate PERT members from other ward personnel.  Rather than initiate ward rounds and spending their entire shift interacting with patients (as was the intent), PERT members remained off the wards to await to be called to a ward AFTER the patient had already begun to escalate (defeating the purpose of PERT).  


When complaints regarding PERT were initially issued, specific statistics were provided to imply that there had been a sudden reduction of ALL assault events in Forensic Center of WSH.  The information provided in the statistics was misleading.  To understand how this PERT issue got out of control, one has to understand the chain of command at Western State Hospital.


The CEO of Western State Hospital is responsible for all business affairs, NOT clinical care decisions.  The Medical Director (the actual “clinical care CEO") must be a properly credentialed health care professional (physician) who IS responsible for all clinical care decisions at Western State Hospital.  Clinical care leadership is defined in the Western State Hospital Medical Bylaws (which are not currently being followed).  It is possible to have a CEO and Medical Director be the same person IF the CEO happens to be a properly credentialed health care professional.  This has happened on several occasions in the past at Western State Hospital.  The current CEO is not a properly credentialed medical professional who can assume those duties. 


The root of the problem with PERT was that the CEO placed PERT outside of the clinical chain of command and oversight of the Medical Director chain of command in direct violation and opposition to the Medical Bylaws.  PERT reported directly to the CEO.  When a seclusion or restraint incident occurred, a cell phone call would go from PERT to the CEO and the CEO would coerce clinical personnel to modify the clinical care initiated by credentialed clinical professionals (Physicians & RN’s).  This manipulation was apparently done to skew statistical data.   Written documentation of the CEO (sight unseen) ordering patients out of restraints and seclusion exists, even though the CEO has no proper authority issue such a directive.  When confronted, the CEO denied this and implied that the credentialed health care provider made his or her own decision when prompted by the CEOs’ actions.  RN employees who were on probationary status that complained about PERT were terminated.  One such case is now headed for civil court.  The CEO ordered that RN4’s were to place into each employees’ evaluation that the employee supports PERT.  At that time employees considered PERT to be what they called the CEO’s “Gestapo” or the CEO’s own personal police force which acted completely outside of clinical oversight.  


When issues with PERT became acute, clinical records for the Forensic Center were requested for review for a one month period.  The result of the review was that there was NO FORM of clinical record of PERT assistance to patients in any patient record.  There was no record of PERT making ward rounds regularly.  There was no record of PERT assignments of responsibility, such as being assigned a specific ward to cover.  In short, it DID appear that PERT was the CEO’s personal police force within the Forensic Center.  PERT operated outside of all clinical supervision and oversight.


Meetings were held where Physicians & RN’s demanded that PERT fall under clinical supervision as was mandated by the Medical Bylaws.  It was requested that, just as occurs with physicians & RN’s, that identification of which PERT member that reports to duty would be published at the beginning of each shift.  It was requested that PERT also be present on the ward at all times during the PERT members shift (rather than waiting to be called to a ward) and that the PERT member be identified who was responsible for a specific ward.  It was made clear that PERT was not to interfere with the clinical judgement and orders made by credentialed clinical professionals. None of these measures were implemented by the CEO.  The physicians held and passed a no confidence vote on the CEO.  There was also question regarding what professional clinical credentials should be required for PERT members as PERT was never chartered through the Medical Bylaw process.


What was the result of these actions?  Our Medical Director was “let go” by not renewing his contract with the University of Washington.  Western State Hospital has no Medical Director at this time.  Our next level of physician chain of command was suddenly vacated from WSH…  Apparently reassigned for investigation with a cover story of “medical issues.”  I suggest that an investigative reporter speak to both of these physicians.  PERT continues to report directly to the CEO and the legislature has apparently funded expansion of PERT in lieu of additional direct care positions, most likely because information of the Joint Commission report was apparently purposefully withheld from them.


The situation was reported to the Joint Commission.  The document that resulted was suppressed from common knowledge as well as the legislatures’ knowledge.  Read the Joint Commission’s findings here.  Has PERT decreased assaults in CFS?  Decide for yourself.  


F1 Assault Data
F2 Assault Data


© Paul Vilja 2017