NMCSD's Inpatient Mental Health Clinic Provides Quality Care

SAN DIEGO (NNS) -- Naval Medical Center San Diego's (NMCSD) Inpatient Mental Health Clinic has passed its first inspection by the County of San Diego since the county's revamp of its inspection procedures.

Personnel from the county's Health and Human Services Agency's Behavioral Health Services Division and the Jewish Family Service Patient Advocacy Program conducted a walkthrough of 1 North, the 24-bed inpatient ward. They checked the ward for cleanliness and safety; ensured a space was present for seclusion and restraint; examined the availability of telephones, visiting and common areas; and ensured staffing requirements were met. They also verified posters conveying patient rights and phone numbers to patient advocates were prominently displayed in multiple languages.

In addition to a review of the clinical space, the inspectors examined patient charts to ensure compliance with documentation standards, and scrutinized the clinic's policies and procedures to determine if they were well written, up-to-date and in compliance with patient rights.

Warren Klam, director, NMCSD Mental Health, said the inspection's success was made possible by the dedication of the staff assigned to the Inpatient Mental Health Clinic.

"The impressive results of the LPS inspection are a reflection of the overall quality of care delivered throughout NMCSD and of the support provided by hospital leadership for the mental health team," said Klam. "The multi-disciplinary inpatient team has truly pushed the envelope for superior quality and safe mental health care delivery."

Mike Phillips, director and supervising attorney, Jewish Family Service Patient Advocacy Program and one of the inspectors present during the visit to NMCSD's Inpatient Mental Health Clinic, shared his impression of the clinic's staff and their performance during the inspection.

"The staff at NMCSD bent over backwards; they were kind and easy to work with and were willing to meet with us before the inspection which made the whole process go that much smoother" said Phillips. "It was probably one of the smoothest and easiest inspections we've ever done. Everyone was just ridiculously over-the-top kind and professional."

The inspection was conducted to ensure the inpatient clinic adhered to the provisions of the Lanterman-Petris-Short (LPS) Act of 1967. Mentally-ill patients may admit themselves for psychiatric care or, in the state of California, they can be admitted involuntarily under the LPS Act when the patient presents a danger to themselves or others, or is gravely disabled and unable to care for themselves. The act, signed into law by then-governor Ronald Reagan, brought much-needed changes to mental health treatment.

"In the 1960s when the civil rights movement was going on, there were all these horror stories of people being locked up and doped up, and then people started to ask, 'how can we balance individual rights with the need to provide treatment?'," said Phillips.

The LPS Act brought improvements to patient care, established methods to safeguard patient rights, and changed the way the public viewed and responded to mental illness. Today, LPS-designated facilities like NMCSD have the ability to place high-risk patients on an involuntary hold for 72 hours or 14 days, as specified in California Welfare and Institutions Codes 5150 and 5152, respectively. Placing a patient on an involuntary hold affords the patient the opportunity to receive more intensive care, engage in positive skill-building activities, and eventually be restored to full function, according to Phillips.

NMCSD's Inpatient Mental Health Clinic is responsible for providing the best care available within the parameters of the LPS Act. San Diego County is responsible for identifying LPS facilities and ensuring they adhere to the LPS Act.

It is also within the county's power to ensure LPS-designated facilities like NMCSD's Inpatient Mental Health Clinic continue on their path to providing the highest quality care for those who are in the greatest need.

"If we noticed anything missing, we made sure the clinic staff had it so they were set up for success," said Trang Tran, Quality Improvement Supervisor for San Diego County's Behavioral Health Services Division. "It's a collaborative process, not a punitive one. We're here to ensure everything's covered and the clinic is following through with LPS guidelines and state guidelines to provide the best care possible."

"Following the inspection, the county asked if NMCSD would be willing to host leadership from other county facilities in order to share design improvements and showcase new technologies," said Cmdr. Jon Deinard, Senior Medical Officer, Directorate for Mental Health. "There has been notable interest to date and the ward was even visited by a director of nursing from a local hospital. The opportunity to share best practices and learn from each other is important and truly helps to advance patient safety and improve the delivery of clinical service to patients across the County."

NMCSD's Inpatient Mental Health Clinic's next inspection will be due in approximately three years.

For more information on Naval Medical Center San Diego, visit www.med.navy.mil/sites/nmcsd, www.facebook.com/nmcsd, or www.twitter.com/NMC_SD .

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