Working Through Uncertainty to Care for Patients in Mental Health Crisis

August 14, 2014

Almost immediately after we sent out Weekly Report last week, the state Supreme Court issued its ruling In re the Detention of: D.W., a court case over psychiatric boarding in Pierce County.

The ruling was crystal clear and wide-reaching. It is not acceptable for the state to detain patients in hospitals when there is no mental health treatment available.
This was the position that WSHA and seven other organizations took when we filed an amicus brief in the case earlier this year (read the brief and see the supporting organizations here). What I said then is true now: It is grossly unfair to patients and families to board mental health patients in crisis when they need specialized care in a secure, comfortable environment. Emergency departments cannot offer the kind of care provided by an evaluation and treatment facility, and it’s critical that the state begin to adequately provide access to mental health services.

The decisive ruling came without remedy or time requirements. Initially, many thought that the ruling was in effect immediately, and even current patients could not be detained for their own safety. It was unclear what was supposed to happen to patients who were in crisis, when there was nowhere else for them to go.

After some work on the part of WSHA and the involved state agencies, it is our understanding that Supreme Court rules allow for a 20 day reprieve. On Friday night, with everyone working late, the Governor’s office confirmed to WSHA, the Washington State Medical Association and all of our members that we would not be forced to discharge our patients who were in psychiatric crisis. We were able to get the word out immediately (read the message), and single-bed certifications were issued throughout the weekend to the patients who needed them.

A solution is not immediate, but we know this issue has the attention of Governor Jay Inslee, who is working with state agencies on a proposal to address this immediate crisis. We have submitted a document outlining policy options to address some of these issues to staff at the Governor’s office.

There are considerable challenges ahead and we look forward to working with our partner organizations and the state to improve our mental health care system to the point where the need for psychiatric board disappears.

Scott Bond
WSHA President and CEO

Medicaid Quality Incentive – Answers to Frequently Asked Questions

Measurement for the 2014 Medicaid Quality Incentive (MQI) is now underway. To help hospitals make the most of this opportunity, WSHA is providing an updated Frequently Asked Questions (FAQ) section on our website. The page provides general information on the incentive as well answers to questions on specific MQI-related measures. The page includes examples and instructions for data submission and links to helpful documents, instructional videos, examples and additional resources. You can find the FAQ page here. For more information on the MQI, contact Amber Theel at (Rebecca Snyders,

Seeking Personal Stories From End of Life Experiences

We know that everyone has a story about the end of life. Maybe it is about losing someone close. Maybe it is about what it was like to have the conversation about your loved ones wishes. Or, maybe it is about not knowing your loved ones wishes until it was too late. Honoring Choices Pacific Northwest, an initiative to promote advance care planning efforts, is searching for personal stories to share on their website to help others learn from your experiences.

In answer to the Medical Officer Collaborative’s Call to Action, the Washington State Hospital Association is partnering with the Washington State Medical Association on the Honoring Choices Pacific Northwest initiative. The goal is to promote patient centered care at end of life by improving the ability of health care delivery systems to receive and respect patient’s choices about end of life care. We will accomplish this through educating and preparing consumers and clinicians for early care planning conversations in advance of serious illness.

We are looking for people from all walks of life to share their personal story. If you have a story you would like to share, please send email your story of 500 words or less to Tanya Carroccio, or if you know some one who might like to share their story, please pass this request along to them. Thank you for being a part of this initiative! (Tanya Carroccio,

Save the Date! Skills Building Intensive for Trustees and Commissioners, October 14

Hospital and health system board members are invited to spend a day enhancing their skills and refreshing their knowledge of good governance during this annual day of learning hosted by WSHA and the Association of Washington Public Hospital Districts. This year’s event  “The Nexus of Strategy and Governance in Times of Disruptive Change” with Pamela R. Knecht, President and CEO of ACCORD LIMITED will take place on Tuesday, October 14 from 10:00 a.m. to 4:15 p.m. at the Edgewater Hotel in Seattle.

For nearly two decades Pamela has focused on assisting not-for-profit hospitals, health systems, and membership associations, as well as for-profit physician clinics and closely-held businesses with strategic planning; governance assessment, restructuring and development; organizational diagnosis and change management; team effectiveness; physician alignment; and merger/affiliation facilitation. Pamela’s presentation and an interactive discussion will:

  • review the changes occurring in health care including the transformation to integrated and accountable care systems
  • describe the importance of leadership during times of disruptive change
  • explain the role of the board in setting and monitoring strategic direction
  • share governance structures and practices used by leading-edge boards of both public district and private, not-for-profit hospitals/systems.

The day will begin at 8:00 – 9:30 am, with an optional board orientation brief for new trustees and commissioners.

Whether you are a board member for a public or private health care organization, don’t miss this opportunity to compare the challenges and opportunities you are facing with board colleagues from around the state. On-line registration for the WSHA Annual Meeting and the WSHA and AWPHD Skills Building Intensive will open August 20.  For further information contact Deborah Swets. (Deborah Swets,

Nominations Open for 27th Annual Joe Hopkins Memorial Award

The Joe Hopkins Memorial Award was created in 1987 to acknowledge an individual who displays the spirit of Joe Hopkins’ vision and dedication to Washington’s hospitals, with a special focus on his interest in rural health. As in the past, the award will be presented at the Washington State Hospital Association 2014 Annual Meeting, October 15-16, 2014.Read more. (Jeff Mero,

Keep Up With WSHA’s Patient Safety News

Patient safety is a huge part of the work done by WSHA and our members, and you need to stay informed and aware of everything that’s happening. That’s why we have a newsletter dedicated exclusively to Patient Safety news. It’s called Leading Quality and Safety, and here are some of the subjects featured in our most recent edition:

  • Hospital Disparity Efforts to be Highlighted
  • Medicaid Quality Incentive Important Updates
  • Join the War on Bugs: New Initiative Aims to Ensure Appropriate Antibiotic Use
  • Qualis Health Awarded CMS Contract for Quality Improvement Program
  • Joint Commission Issues Event Alert on Vial Misuse
  • Handwashing: It’s for Patients Too

To read the newsletter, view it on-line here or visit our website here and subscribe! (Mary Kay Clunies-Ross,

WSHA On-line Bookstore – Affordable Patient Safety Publications for Your Hospital

Since 2005, the Washington State Hospital Association has offered our members printed materials to give their patient safety efforts a boost. The WSHA on-line bookstore has distributed over 2.3 million pieces of literature including information for patients and staff on infection control, isolation signage, hand washing, ER usage and patient and family engagement. The literature comes in a variety of formats such as brochures, posters, table tents, and even tray liners. Most are offered at cost or are free or available for download. If you haven’t taken advantage of this great opportunity yet, be sure to check the store out here. (Rebecca Snyders,

Industry Partner Spotlight: Incyte Diagnostics, Pathologists Partnering with Hospitals

Incyte Diagnostics is a new Washington Hospital Services Industry Partner providing access to the best pathology expertise at a reasonable price. We’d like to share with you some insight from Dr. Ira Allen on working with Incyte Pathology.

“As the medical director for Valley Medical Center Clinical Laboratory, and as a pathologist representing Incyte Diagnostics, I have seen firsthand the many ways hospitals benefit from a partnership with Incyte. Incyte has provided medical directors and clinical laboratory consultative services in the Pacific Northwest for over 50 years. Directors are experts in both anatomic and clinical pathology as well as laboratory medicine, and actively support the hospital’s administrative and medical staff functions. Pathologists serve as committee members and board members, in addition to successfully preparing hospital laboratories for inspections by the College of American Pathologists, which is necessary for a hospital’s accreditation by the Joint Commission. Partnering with clinical colleagues to provide the highest level of care while also keeping a well-trained eye on controlling costs in laboratory medicine, Incyte pathologists employ a team approach to significantly reduce costs without compromising the quality of laboratory services. This practice is an all around “win-win-win” for hospitals, patients, and physicians.”

To learn more about how the expertise and experience of Incyte Diagnostics can benefit your hospital, please visit their website at and when you contact Incyte, be sure to mention the WHS Industry Partners program! (Yvonne Polk,


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