AGENCY TESTIMONY
Concerns about Intro 423: Publicly naming CHS employees in death investigations
1:25:48
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142 sec
Dr. Subedi expresses strong opposition to aspects of Intro 423, particularly the requirement to publicly name CHS employees involved in circumstances contributing to deaths in custody. He outlines the potential negative impacts of this requirement on healthcare staff and patient care.
- Explains how publicly naming staff contradicts recommendations from professional organizations
- Highlights concerns about deterring frank discussions and exhaustive reviews of adverse events
- Emphasizes potential negative effects on staff morale, retention, and recruitment
Bipin Subedi
1:25:48
CHS strongly opposes several specific aspects of intro423, which require the New York City Board of Correction or BOC to issue a public report on its stigations into the deaths of individuals in custody of the New York City Department of Correction and to include the names of CHAS employees whom the board determined were, quote, involved in the circumstances that contributed to, unquote, the deaths.
1:26:11
This bill would also require CHS and DOC to conduct a joint investigation of each death of an individual custody of the department, including the review of all medical records, and to submit a joint report of the findings to DOC.
1:26:23
It would also establish a jailed death review board with CHS participation in order to identify systemic issues that contributed to such deaths.
1:26:31
Finally, the bill would require a public report on individuals who have been released from custody due to a medical condition.
1:26:40
We have serious concerns about the bill's requirement that BOC published the names of CHS employees involved in the circumstances that contributed to a death.
1:26:49
Publicly naming healthcare staff following an adverse clinical event contradicts the approach recommended by national professional organizations such as the American Medical Association and the American Nurses Association.
1:27:00
These groups caution against an unnecessarily punitive approach precisely because it promotes a culture that deters disclosure and Frank interspective, and exhaustive discussions of the events surrounding adverse clinical events.
1:27:13
They also recognize that there's a range of accepted clinical practice with within which clinical judgment is exercised and that the context in which healthcare delivered should be considered in reviews.
1:27:24
Reviews are best conducted by individuals who have had the clinical expertise and nuanced understanding of CHS workflows and the actual clinical and environmental circumstances of the time care was rendered.
1:27:36
Retrospective reviews, especially if conducted by non clinicians unfamiliar with this unique context, can result in second guessing after the fact.
1:27:45
Given this, publicly naming CHS staff may not only risk mistakenly attributing an adverse event to a clinician, but could also serve to minimize and distract from the complexity of care delivery in the jail environment, including the impact of jail operations on individual health.
1:28:00
This will adversely affect CHS morale, retention and recruitment, and would interfere with our ability to investigate, identify, and remediate root causes in order to prevent recurrences.
