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Dr. Karen Kent VanGorder, senior vice president and chief medical and quality officer at Sparrow Hospital in Lansing, asserted last week that more than 90 deficiencies uncovered in a safety inspection by The Joint Commission had since been “entirely resolved.”
But internal staff emails still point toward outstanding concerns.
In emails sent to hospital staff on the same day as VanGorder’s interview with City Pulse last week, Alan Vierling, president and chief nursing officer of Sparrow Hospital, warned staff that “the hardest part of the journey” had just begun, with yet another TJC follow-up inspection expected at the end of the month.
VanGorder said Sparrow had already been cleared by TJC before those surveys have even occurred at the hospital.
“This is where we simply must keep doing all the things we’ve been doing,” Vierling wrote in emails obtained by City Pulse. “We must form habits. It isn’t hard to correctly chart restraints, or meds, or blood transfusions. It is simple adherence to detail. It is critically important, and it is part of our job. Habits take a while and you have to maintain focus.”
Officials have declined to elaborate on the findings of a recent report that dinged Sparrow for more than 90 safety deficiencies uncovered in an unannounced inspection in April. The hospital was subsequently issued a preliminary denial of accreditation that VanGorder still expects to be overturned within the coming months.
She told City Pulse that Sparrow had been “thoroughly inspected” and passed “even the most rigorous” subsequent investigations to become “completely in compliance” with TJC standards. The overarching message: Sparrow had potentially messed up, but the hospital took quick action and was able to make it out of the woods.
Two days later, Vierling was bribing nurses with candy to bring the hospital into full compliance, emails showed.
“Right now, if you checked your chart, is it all there? Is your area up to speed and compliant? I’ll bring a Snickers bar to the first nurse who emails me their chart is perfect and a Snickers bar to the first non-nurse who emails me about a perfect work environment. We have 18 days left, I’m excited about our next opportunity,” he wrote.
Accreditation from TJC— an independent nonprofit that inspects and accredits about 80% of U.S. hospitals on a series of safety measures — is required for the hospital to accept Medicare and Medicaid payments. In emails to staff, Vierling noted the “bottom line” of the preliminary accreditation snag was centered on hospital finances.
“Without (accreditation), we do not get paid, we cannot admit elective patients, nor do elective procedures. Everyone must adhere to the very reasonable standards all the time. It is not okay to participate occasionally. We need to get it right all the time,” Vierling added in a recent email. “No accreditation means no business.”
He also emphasized that the inspections were a motivator, but subsequent improvements are focused on “better, safer care to our patients” and “giving our community an exceptionally good experience” at Sparrow Hospital.
Recurring safety inspections, according to a TJC spokeswoman, are unannounced — presumably so hospitals aren’t afforded an opportunity to artificially meet standards just for a site visit. Vierling’s emails, however, provided some precision estimates (counting down to 18 days) for the commission’s upcoming followup visit.
VanGorder insisted Vierling’s emailed estimations were simply his best, ballpark guess.
“They are definitely unannounced,” VanGorder clarified this week. “They have to come back every 45 days. They did come back. We were resurveyed and nothing was found. All of the citations were resolved. We don’t know exactly what day they’ll return, but this is all part of their process. Those issues have been resolved.”
A TJC spokeswoman declined to comment when asked about Vierling’s estimations for another inspection.
VanGorder also again declined to elaborate on the vast majority of vague concerns identified in the May 24 report, including dozens of listed citations for incomplete operative notes, unlocked anesthesia carts, improper medication labeling, inadequate identification of patients at risk of suicide and numerous other issues.
Vierling’s emails to staff also emphasized the importance of proper pain and fall assessment techniques along with streamlined procedures in the emergency room, the “canary in the coal mine” for the hospital where 65% of all patients arrive, he noted. “If anything is broken, anywhere in the hospital, the ED feels it first,” he wrote.
Vierling also addressed the recent coverage in City Pulse before pointing to areas that need improvement.
“We tried to explain that all of our issues have been solved. The story ran anyway.”
TJC issues preliminary denials when hospitals either create an “immediate threat to health or safety of patients or the public,” or do not comply with commission standards, according to its website. Fewer than 1% of hospitals nationwide were denied accreditation last year. The preliminary denial was a first for Sparrow.
“These are all potential problems and not actual problems. No patient care was affected by any of these things,” VanGorder said previously. “We’re in constant contact with TJC. They have reassured us that it’s taken care of.”
A review for a final determination is still underway. The hospital, in the meantime, maintains its accreditation status while online reports still list at least 48 non-compliant safety standards at the hospital, including the competence of staff to perform their abilities, infection prevention and education about follow-up treatment.
After City Pulse published the findings earlier this month, more than 500 copies of the newspaper vanished from Sparrow facilities that had received them. A front-desk staffer said the papers were removed over a “negative” story. Hospital officials later denied knowledge of their recent disappearance. They’re still missing. The following week’s issue, however, was allowed to remain.
Visit lansingcitypulse.com for previous and continued coverage on Sparrow Health System.