RI Chief Medical Examiner Placed on Leave Following Accreditation Downgrade
Thursday, July 23, 2015
Dr. Christina Stanley, the Chief Medical Examiner for the State of Rhode Island, has been placed on paid administrative leave, according to the Rhode Island Department of Health -- which recently had its full accreditation revoked from the National Association of Medical Examiners (NAME) and downgraded to provisional.
"[Stanley] has been placed on administrative leave as of today," said Christina Batastini, public information officer for the Department of Health. "When our new Director of Health took office, she made it clear that she was going to address the structure, staffing, and leadership in the department, and this review and paid leave was part of that process."
Batastini said that she couldn't go into further detail, including when -- or if -- Stanley would return to her job, or if it was related to the state losing its full accreditation.
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The Department of Health Provided the following statements on its accreditation loss and placement on "provisional accreditation"
The office applied for continued re-accreditation by the National Association of Medical Examiners (NAME) on 12/10/14. We were inspected on 4/6/15. On June 1, 2015 a letter was sent from NAME confirming that the OSME must improve its report turn-around time and staffing for investigations to meet NAME's 2014-2019 standards for full accreditation. We have until 12/10/15 to submit documentation of improvement for consideration for full accreditation or continued provisional accreditation.
At the time of the office's NAME inspections in 2009-10, the number of staff at the OSME was larger and included an investigator position that was never filled. Fortunately, most of the other positions eliminated from the OSME since the 2010 full accreditation have been restored but only over the last 3 years.
When the National Association of Medical Examiners' New Accreditation Checklist was adopted in 2014, the OSME noted that it had never consistently met the report turn-around times specified in this checklist. While most other new/revised requirements were already in place and many others were corrected, we were not able to correct the report time turn-around deficiency by the time of our site inspection in April of 2015.
The office said that a link to the definition of full -- and provisional -- accreditation can be found here.
Working on Improvements
The Health department addresses how it plans to move forward
We are currently working on improving report turnaround and staffing for investigations. Since the April inspection, reclassifications of existing OSME employees have been put in place that provide more staffing for investigations which will hopefully rectify this deficiency. The office is also recruiting a forensic pathologist/assistant medical examiner to fill a recent vacancy (Not present at the time of the inspection.)
In 2013, the OSME finished 78% of examination reports in 90 days. In 2014, 74% were finished in 90 days.
At the time of the NAME Inspection in April, the OSME had only 5 Medical Examiner Investigators to triage phone calls and faxes that the OSME receives regarding over 5,000 deaths reported to the OSME each year. As part of this triage and extensive investigation performed for deaths that are accepted under OSME jurisdiction, the investigators must contact physicians, hospitals, clinics, police and decedents' families for more information, request medical records, and travel about the state to perform scene investigations 24 hours a day, seven days a week.
In 2014, the OSME investigators performed over 500 death scene investigations compared with under 300 in 2008 and 2009. Delays and missing investigative information results in more work for the medical examiners (physicians) and affects their timeliness in determination of final cause and manner of death and completion of examination reports.
Related Slideshow: Health Data Security Breaches Reported in RI Since 2010
The following are health data breach reports from Rhode Island as listed on the Department of Health and Human Services Office of Civil Rights website.
As required by section 13402(e)(4) of the HITECH Act, the Secretary must post a list of breaches of unsecured protected health information affecting 500 or more individuals. These breaches are now posted in a new, more accessible format that allows users to search and sort the posted breaches. Additionally, this new format includes brief summaries of the breach cases that OCR has investigated and closed, as well as the names of private practice providers who have reported breaches of unsecured protected health information to the Secretary.
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