Summary of the Settlement between the District of Columbia and
the Department of Justice
Treatment will be individualized and supported by a multidisciplinary
team that works together to develop an integrated plan that is modified as
needed based upon the individual patient’s response. The goal of
treatment will be placement of the patient in the least restrictive
environment.
- Treatment at Saint Elizabeths will strengthen and support an
individual’s rehabilitation and recovery. - Patients will be encouraged to participate in treatment goals and
treatment options. - Treatment will be individualized, based upon the patient’s
presenting symptoms and history to meet the needs of each patient’s
goals. - Treatment will be provided by interdisciplinary teams that work
together to address the individual’s needs so that he or she can be
released to the community. - Each patient will have a treatment plan that is updated as needed
based upon the patient’s response to treatment, but at least every
sixty days and which specifically identifies the therapeutic means by
which the treatment goals are addressed, monitored, reported and
documented. - Each patient will receive assessments by the clinical team which
includes psychiatrists, social workers, nurses, psychologists,
pharmacists, and rehabilitation specialists on a regular and as needed
basis, and treatment will reflect these assessments.
Patients will be treated with respect and will be free from abuse and
neglect.
- Seclusion, restraint or involuntary psychotropic medications will be
used only when the patient poses an imminent risk of injury to self or
others and only after less intrusive alternatives have been considered
and determined to be inappropriate. - Staff will be trained specifically in the use of seclusion,
restraint and involuntary medication. - Patients are informed every thirty minutes of the behavioral
criteria for release from the intervention. - The use of special interventions will be of limited duration.
There will be highly qualified staff in a sufficient number to
implement this agreement.
- Additional psychiatrists, nurses, psychologists, social workers,
pharmacists and other staff will be hired to ensure an adequate work
force and to provide proper supervision of patients. Specifically, the
Hospital will ensure each psychiatrist on an acute care ward is not
responsible for more than 12 patients, and for no more than 24 on a
long term care ward. - There will be on going training for all staff on all areas of
treatment including but not limited to best practices in diagnosing
and development of individualized assessments, development of
behavioral interventions, the use of interdisciplinary teams and
development of integrated treatment plans. - Quality assurance measures will be in place for monitoring clinical
practices including behavioral treatment interventions. - Staff will be trained on incident reporting.
Patients will receive treatment in a safe and humane environment.
- Saint Elizabeths will improve its infection control program.
- The Hospital will have the capacity to regularly review the units
and areas of the Hospital to which patients have access for safety. - The Hospital shall update its fire safety and evacuation plan.
- The Hospital shall identify and remove all hazardous and unsanitary
conditions in living units and kitchen areas.
Saint Elizabeths Hospital will have a quality improvement program that
provides for effective monitoring, reporting, and corrective action.
- Within four months, the Hospital will submit corrective action plans
concerning integrated treatment planning, mental health assessments,
incident management, and restraints, seclusion, and emergency
involuntary medication. The plans shall have specific steps to be
taken with timelines and shall identify the person responsible for
implementing the action steps and the quality assurance mechanism to
evaluate the status of implementation. - The Hospital shall implement a comprehensive incident management
program that identifies incidents to be reported, that is responsive
to incidents or allegations of abuse or neglect so that the
individuals involved are protected and that reviews incidents and
develops appropriate corrective and preventative actions addressing
the problems identified. - The Hospital shall have a system that tracks and trends incidents
and the results of actions taken.