Now Accredited, Springfield Could Face Staff Shortage

November 07, 1990|By Anne Haddad | Anne Haddad,Staff writer

SYKESVILLE - A nationwide agency has given Springfield Hospital Center the accreditation it lost nine years ago, but one mental health advocate said she hopes the state hiring freeze doesn't jeopardize the new standing.

"(The accreditation) means we have an acceptable hospital," said Dr.

Bruce Hershfield, a psychiatrist who has been superintendent of the hospital since 1986. "It's not like winning a prize. It's like winning a nod of acceptability."

The Joint Commission on the Accreditation of Health Care Organizations, often called the JCAH, is an independent, non-profit group that evaluates hospitals nationwide. Most hospitals are accredited, Hershfield said. Five evaluators spent four days in July studying the hospital.

"I'm pleased they got the accreditation," said Janice Becker of Berrett, a member of the hospital's Citizens Advisory Board that reports to state Health Secretary Adele Wilzack. "But there's no financial improvement. The advantage . . . is they can attract more highly qualified staff, but what negates that is there's a (statewide) freeze on hiring."

Becker's 28-year-old daughter was at Springfield for four years. She said the hospital has come a long way, but still needs to improve the staff-patient ratio and better control violent patients. Also, she said, the governor needs to put more money toward community programs for patients who don't have to be in the hospital.

Hershfield said some problems, such as the staff-patient ratio, are improving as more patients are released to community programs.

In the late 1970s, JCAH gave the hospital a series of one-year accreditations, on the condition it improve things such as the staff-patient ratio and buildings, Hershfield said. But because the hospital could not meet those requirements within the year allowed, the accreditation ran out in 1981.

In 1987, just after Hershfield became superintendent, he and the staff began working toward accreditation, he said.

The staff-patient ratio is now 2-to-1, including service staff. The hospital now has about 600 patients, compared to 950 in 1986 and 1,400 in 1981. Staffing remains between 1,500 and 1,600, but only 1,200 of those positions are filled because of a year-old state health hiring freeze.

While vacancies include many nursing positions, the freeze has not affected patient care yet, Hershfield said, partly because the number of patients is down and the existing staff is working harder. His requests for exceptions from the freeze to hire more nurses have been denied, so he is "worried about the future."

As the patient census falls, he said, he also can close the units in the worst shape. Unlike in 1981, he said, all patient buildings are at least partly air-conditioned.

The nationwide trend toward releasing patients from mental hospitals as soon as possible is for two reasons, Hershfield said.

"First of all, some people simply do better in the community," learning to live in society instead of the controlled hospital, he said. "The second thing is you simply get more value for your money."

It costs $7,500 a month to treat a patient at Springfield, compared to $1,400 a month for some patients in the community, which can vary greatly, Hershfield said.

The community programs are run by private, non-profit groups such as Carroll Hall and Granite House, that provide housing, job-training and therapy.

The JCAH will return in three years to re-evaluate the hospital, and in the meantime requires the staff to continue to evaluate itself, Hershfield said.

"It also teaches you how to be a better hospital," he said. "We don't want to lose the accreditation."

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