Becker's Hospital Review

52 CMO / CARE DELIVERY A delay in hospital closure is posing patient safety risks, execs say By Mariah Taylor A n ongoing exodus of healthcare workers from Mount Sinai Beth Israel is posing risks to patient safety "in the very near future," Politico reported July 17. e New York City-based hospital had expected to close July 12, but remains open until the state approves its new closure plan. Since submitting its original closure plan in October, around 450 employees have le on their own and the hospital has transitioned many others to different hospitals. "Staffing instability has reached a critical point where we are no longer able to continue reliably providing safe patient care," Liz Sellman, the hospital's president and COO, said in an affirmation filed July 15. "Staffing at the hospital is sufficiently thin and unstable that even a relatively minor event, such as staff calling out sick, could have a debilitating and potentially life-threatening effect at the hospital. ese are not appropriate conditions under which to operate a hospital." Hospital leaders and staff are raising the alarm on the widening staffing gaps in hopes of accelerating the state Health Department's review process and convincing a judge to loosen a restraining order that blocks the hospital from downsizing services. Current and former workers also told Politico they fear quality of care has already suffered due to downsizing services and relocating staff. ey said they consider the situation to be at least partly self-inflicted as the hospital started transferring healthcare workers to different Mount Sinai locations. For example, staffing in perioperative care dropped from 92 employees in December to 33 in March. "We know that all of you who remain at the hospital have been doing everything possible to serve our patients and keep them safe," Beth Israel executives wrote in a memo to staff obtained by Politico. "We are using our best efforts to recruit and to bring in staff from other campuses, temporary (locum) doctors and other providers, and agency nurses to help you provide high-quality care. Despite that, we have not been able to bring in all the staff that we would like to." e hospital is closing due to a decline in emergency medical visits in the past decade, but about 4,000 patients still go to the emergency room every month. Health Department spokesperson Erin Clary told Politico that "the Department has been in regular communication with Mount Sinai leadership regarding staffing concerns and to ensure patient safety. e closure plan remains under review and as a result, the Department cannot comment further." Mount Sinai submitted its initial closure plan in October 2023, then submitted a revised July 12 closure plan aer the health department said the original plan was incomplete. "We chose that specific day because it was the furthest date we believed we could reliably keep the hospital open safely," Brendan Carr, MD, CEO of Mount Sinai, and Elizabeth Sellman, president and COO of Mount Sinai Beth Israel, said in a July 10 internal memo shared with Becker's. "We will, of course, not commence the closure process without approval by the state and until the legal hurdles are cleared, but there is urgency as there are risks associated with keeping the hospital open beyond the proposed date." e department is still reviewing the revised plan. n Penn Medicine hospital lowers CLABSI rate to zero: Study By Paige Twenter P enn Medicine's flagship hospital noted zero central line-associated bloodstream infections in fiscal years 2022 and 2023, according to a study published Aug. 1 in Critical Care Nurse. In fiscal year 2018, the Hospital of the University of Pennsylvania began caring for a new population of patients with pulmonary artery catheters. Compared with fiscal year 2017, the number of catheter days increased from 1,544 to 2,688, and the CLABSI rate jumped from 0.65 to 1.86. The Philadelphia-based hospital adopted "standard, evidence-based CLABSI bundles," the study said, but infection rates barely budged. In fiscal year 2019, a nurse- led initiative introduced central catheter rounds three times a week — and zero CLABSIs occurred. The rounds focused on "critically assessing all central catheter dressings; determining the necessity of each patient's central catheter; and educating patients on the importance of keeping their central catheter dressings clean, dry and intact," according to the study. With the bundles and central catheter rounds, the hospital's CLABSI rate dropped from 1.86 to 0.0 between July 2019 and June 2022. The absence of CLABSIs continued throughout fiscal year 2023. The two infection prevention practices have become the standard of care throughout the hospital, according to a news release from the American Association of Critical- Care Nurses. n

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