News

Modernizing Quality of Clinical Care a Top Priority

The state’s psychiatric hospitals have made important progress during the Murphy Administration and will continue to undergo a major turnaround effort to modernize clinical care and rectify long-standing patient safety and physical plant improvements.

Health Commissioner Dr. Shereef Elnahal today released an Executive Assessment of the hospitals by the New Solutions consulting firm and the Department’s 18-month Action Plan for the hospitals, which outlines significant strides that have already been made including the hiring of 220 clinicians and other staff. In addition, there is also a $23 million capital plan to make critical physical plant upgrades.

“We are changing the culture of the hospitals,” Commissioner Elnahal said. “Since my first day as Commissioner seven months ago, we have focused on enhancing clinical care, improving patient and staff safety while continuing to reduce the census and patient assaults.”

Across the hospital system, there has been a 30 percent reduction in violent assaults to both patients and staff in the first quarter of this year vs. the first quarter last year. In addition, the census at the four hospitals has declined by nearly 60 patients from 1,510 in January 2018 to 1,453 last month.

“As any hospital CEO will tell you, it takes time to improve the quality and safety of care in hospitals,” said Commissioner Elnahal, who has experience in health care quality, patient safety and improvement of troubled government hospitals at the U.S. Veteran’s Administration. "Nevertheless, we are laser focused on achieving sustainable improvements for patients and family members."

“Our vision is to have the hospitals operate as one health system of regional psychiatric facilities using the same clinical and patient safety standards,” Dr. Elnahal continued. “Just like acute care hospital systems or a children’s hospital, our regional psychiatric hospitals should be specialized hospitals where patients are treated, stabilized and then returned to the community–with the supports they need.

“Consistent adherence to the most up-to-date practice standards–while maximizing time between clinicians and patients-improves outcomes and ensures successful transitions to community settings,” Commissioner Elnahal added.

Extensive changes already have occurred at Ann Klein Forensic Center (AKFC), a 200-bed facility in West Trenton for those with mental illness who are involved in the criminal court system. Two weeks before the Murphy Administration began, the Joint Commission informed AKFC that it could lose its accreditation if it did not end a long-standing administrative lock-in policy in place on certain shifts.

Under the leadership of the Department’s new Deputy Commissioner Deborah Hartel, Assistant Commissioner Valerie Mielke, and AKFC CEO David Kensler, AKFC retained its accreditation by ending administrative lock-ins, hiring 111 staff and making anti-ligature improvements to prevent patients from harming themselves. Other improvements include making sure that appropriate labels with expiration dates are in place for all medications and having a pharmacist review 100 percent of patient charts monthly to ensure that allergies and adverse drug reactions are clearly separated and listed.

Another hospital that has demonstrated strong performance is Ancora in Winslow Township. It was recently cited by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) as a national leader in integration of trauma-informed care, which recognizes that past traumatic experiences can affect a person’s mental well-being.

Greystone in Morris Plains has increased supervision and oversight on one-to-one monitoring to ensure patient safety, opening up more time for clinical staff to spend with higher acuity patients.

In addition to Deborah Hartel as Deputy Commissioner for Integrated Health, Commissioner Elnahal also announced today that a new CEO was named for Greystone Park Psychiatric Hospital.

Hartel joined the Department five months ago after more than 20 years at St. Joseph’s Health in Paterson. She also spent 17 years at the former St. Mary’s Hospital in Passaic. She as an extensive background in hospital management and quality improvement in other behavioral health facilities. She is overseeing the psychiatric hospital improvement with Valerie Mielke, the Assistant Commissioner of the Division of Mental Health and Addiction Services. 

The new CEO at Greystone is Tomika Carter, who became acting CEO this summer. Carter most recently worked as the Associate Executive Director at Bellevue Hospital in New York, where she also has served as an in-patient psychiatric coordinator, addiction counselor, caseworker and discharge planning supervisor. She also worked as a case manager and discharge planner at Rikers Island. A new medical director and chief nursing supervisor were also hired in recent months. Despite a national and state shortage of psychiatrists, hiring of clinical staff is an ongoing priority.

The Department’s Action Plan is based in part on recommendations contained in an Executive Assessment by New Solutions, a consulting firm hired by the previous administration to evaluate hospital operations. The Executive Assessment, the Department’s Action Plan in response to the Executive Assessment and a Fact Sheet are available on the Department’s website at https://nj.gov/health/integratedhealth.

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