HOSPITAL Psych unit placed on probation over force

The hospital reported 11 times when force was used during two years.
CINCINNATI (AP) -- The psychiatric unit at University Hospital has been placed on probation because officials failed to properly justify every use of stun guns or pepper spray to subdue patients.
Workers at the unit must do a better job of explaining the reason for their actions on reports filled out each time force is used on psychiatric patients, the Ohio Department of Mental Health has told hospital officials.
"We did not find consistently appropriate justification for use of force in their documentation," Laura Wentz, spokeswoman for the Mental Health Department, said Friday.
Hospital spokeswoman Patty Thelen said the hospital is cooperating with the state agency, but it disagrees with the assignment of probation and has filed a formal response.
"We're working with them to correct the situation," Thelen said.
The psychiatric unit has 70 licensed beds and can continue to accept patients.
"Probation status does not interfere with daily activities," Wentz said. "It just alerts them that we are closely monitoring them."
What was reported
Based on reports submitted by the hospital, state mental health officials visited Feb. 15. Anita Lieser, acting chief of the department's office of licensure and certification, told the hospital by letter Feb. 28 what investigators found.
She said University Hospital reported 11 use-of-force episodes during a two-year period, a number significantly higher than at any other licensed or certified facility in the state.
Wentz said not all of the 11 cases were improperly justified.
"Although it sounds high, we have an incredibly high volume," said Lee Ann Liska, vice president of operations at University Hospital. "What's important to emphasize is that these incidents are extremely rare."
Liska said the hospital's figures vary slightly from the state's because of different reporting procedures. She made available numbers from the past 4 1/2 years since the start of the hospital's fiscal year in July 2001.
The hospital recorded seven instances of force being used among 13,251 patients who were admitted and six uses of force among 56,084 patients in its psychiatric emergency room.
The hospital's reports failed to document what behavior patients exhibited to warrant force, what attempts were made to avoid using weapons and what vital signs were taken following their use, the letter said.
Instructions
"University Hospital must take immediate steps to assure that your program maintain the least restrictive interventions and effectively document such intervention when necessary with an aggressive and symptomatic individual," Lieser wrote.
The letter suggested a plan to correct the hospital's reporting deficiencies.
"The hospital has been very cooperative," Wertz said. "Once we receive their plan of correction and approve it, the probation would be lifted."
Officers used force when patients exhibited criminal behavior, Gene Ferrara, director of the University of Cincinnati's public safety department, told The Cincinnati Enquirer.
"In some cases, [patients] had picked up items -- lamps. There was one case I know of where a chair was broken, and the leg of the chair was being used as a club," he said.
Because of the state action, university police will take uncontrollable patients to the Hamilton County jail, which has a hospital unit, Ferrara said.