Editor's note: This is No. 5 in The Tribune's Top 5 Stories of 2012 as selected by the newsroom staff. Each day through New Year's Day we will count down to the top story of the year.
Hit with another year of assaults on staff and a new wave of costly state violations for not keeping its employees safe from the mentally ill and violent patients they care for, Atascadero State Hospital is taking another look at streamlining its procedures and training.
Hundreds of employees at the maximum-security facility are consistently spat on, punched and shoved in incidents year after year, some of which lead to serious injury and hospitalization.
This past year has seen a sharper focus on safety after employee complaints brought state safety investigators into the facility, prompting hospital administrators to streamline practices with investigators and staff.
Still, some employees don’t think the new measures are strong enough.
State investigators found an average of 10 staff injuries per month from patient attacks through September and said the hospital didn’t effectively protect staff from violence. More recent figures from 2012 won’t be available until early in the new year.
The California Division of Occupational Safety and Health fined ASH a total of $64,230 in the spring and fall. Construction of a new hospital alarm system next fall, which psychiatric technician Tessa Linhares said is “really our only recourse to stay safe,” is slated to ease concerns.
Linhares is secretary of the ASH chapter of California Psychiatric Technicians.
Until then, safety investigators, administrators and union officials statewide are working to clarify existing rules.
“The jobs here are inherently risky, and you know that you cannot reduce the number of injuries to zero, but you do need to make sure you have good processes, procedures, response mechanisms and policies,” said Kathy Gaither, chief deputy director of the Department of State Hospitals. “It’s really more of all of us thinking differently and working together.”
For example, the group examined procedures in responding to the hospital’s emergency alarms, studying everything from how many people should respond when an alarm goes off to where people should go.
“Those are the basic fundamental building blocks of safety — having well thought-out procedures and having people follow them,” Gaither said.
But Linhares said her group thinks meetings are not enough.
“We have seen the pow-wows with them asking us for the tips and trying to reiterate some rules, but it’s the functionality of the hospital that’s the problem,” Linhares said.
For her group, that means there are not enough people working per shift for employees to feel safe, she said.
Another year of violence has brought employee morale to “an all-time low,” she added.
Psych techs, part of the forensic hospital’s nursing staff, provide patient care 24 hours a day.
About 2,100 employees work at ASH, which is licensed for 1,275 beds. The hospital runs on patient-to-staff ratios set by the state.
Those minimums, Linhares said, are usually met by implementing mandatory overtime that wears employees down physically and emotionally. Hospital administrators aren’t proposing any changes to staffing levels but may reappraise the situation if they get more patients, Gaither said.
New alarm systems are being rolled out to the state’s five mental hospitals now, with Napa State Hospital as the test site. The 2010 strangling of Napa psych tech Donna Gross left that facility shaken.
ASH’s new alarm system is tentatively slated for installation in fall 2013 with implementation in 2014, hospital Executive Director Linda Persons said.
The state’s fines are part of a move to consolidate more than $200,000 in citations against California’s five state hospitals — Atascadero, Coalinga, Napa, Metropolitan and Patton.
“We see we have a systemic problem, and we need a systemic solution,” Gaither said.
The Tribune's top stories of 2012
1. PG&E's plans to conduct seismic surveys offshore of Diablo Canyon nuclear power plant | 2. The ban on disposable plastic bags at SLO County retailers | 3. Accreditation and budget challenges at Cuesta College | 4. The Lisa Solomon controversy in the Paso Robles Police Department | 5. Violence by patients on staff at Atascadero State Hospital