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‘October §, 2017 (Ms, Wala Blegay, Esq, ‘Washington, DC 20016 Dear Ms. Blegay: “The recent decision by the D.C. Nurses Association (DCNA) to issue a “no confidence” vote against United Medical Center (UMC) and our leadership team is not supported by the facts. According to the Washington Busines: Journal, which is our only source for communication on this issue since DCNA did not reach out tc the hospital with its concerns, you accuse UMC of having “ignored nurses’ alls to address unsafe nurse-patient ratios, a lack of proper equipment in units, and inadequate nurse training.” ‘With regard tothe charge of unsafe nurse-patient ratios, UMC takes quality patient care ‘seriously. When Maribel A. Torres joined the staff four years ago, she immediately instituted a ‘comprehensive staffing plan fora nurse-patient ratio, The plan was based on national standards as ‘specified in position statements from numerous organizations, including the Association of ‘Operating Room Nurses, the Association of Woman and Neonatal Nursing, Academy of Medical Surgical Nurses and Association of Ctical Care Nursing. “Earlier this year, a a result ofan inercase in patent census, the plan was modified to identify flexible staffing levels based on specific clinical variables rather than a mandated nurse-to-paient ratio, Those variables can include patint acuity, the numberof admissions, discharges and transfers, ‘geographic layout of the unit and avai ability of resources including support staff, process 1910SOUTHERN AVENUE, SE WASHINGTON, OC, 200124628 + 2025745000 + WNW/UNTED-NEDICALCENTER-COM ‘automation and supplies. For a community hospital such as UMC, this was an important step in ensuring patient safety ina fiscally prudent manner. We communicated the revised guidelines to our nurses and gave a copy to DCNA’s labor attorney. We monitor staffing and adjust nurse-to-patient ratios as needed every four hours and staffing ‘compliance is reviewed daily. Despite struggling with high percentage of our nursing staff aking. sick leave, we have met our targeted nursing ratios in the ICU ninety percent (90%) ofthe time and in our Medical Surgical Units eighty percent (80%) ofthe time. With regard tothe charge ofa lack of proper equipment in units, UMC has made significant ‘enhancements and improvements to equipment in support of our nurses. These enhancements include: purchase of new patient beds; installation ofa new call bell system and overhead paging system; purchase of 15 new mobile computers and additional desktop computers at nursing stations for nursing documentation; addtional heat, EKG and blood pressure monitors; new ventilator; and ‘new lifting equipment for safe transfer of patients. In addition, we have installed additional cameras ‘and emergeney call boxes in the parking lot and patient care areas to enhance safety for staf. We have also remodeled UMC's 5 and 8 floors with improved nursing environments and refurbished several new surgical operating rooms. In fact, these upgrades have represented a significant improvement in patient and staff safety and comfort across the hospital. Finally, with regard to the charge of inadequate nurse training, our education department offers a range of “live” and online classes for nurses to expand their knowledge and further their professional evelopment. We also offer tuition reimbursement, and coverage for costs related to all nursing certifications, CPR and ACLS classes, ‘We have communicated these upgrades and opportunites to all UMC nurses and provide an ongoing platform for nurses to voice concems, review internal processes effecting their daily workloads and offer solutions. ‘We have reached out on a consistent basis to DCNA with changes as they occur and have offered several opportunities for DCNA staff to attend Town Hall meetings to raise concerns. In response tothe notice, we took immediate steps to comply with the order to temporarily close the (Obstetrics unit, We are curently inthe process of analyzing and reviewing the steps necessary to address these issues with the goal of submitting a plan to DOH on the future of obstetrics at UMC. ‘We recognize the importance of obstetrical services to our community and this Administration is ‘committed to working with our Board and the hospital's Quality and Safety Board Committee to provide a plan to DOH that will outline the steps and resources needed to address the future of UMC’ obsterical services. Ata minimum, this process will require the identification of obstetrical physician practices that serve our community and could ailiate with UMC to create a suitable pipeline of patients who will have access to the resources that every pregnant mother needs to ‘experience & healthy pregnancy and birth throughout the maternity cycle. ‘UMC remains dedicated o te health and wel-being of individuals and communities entrusted in ‘ur eare and we stan firm in our commitment to provide quality health care serves for Ward 7 and Ward 8 residents. ‘We would welcome the opportunity to meet with you in person to address these concer. Al ornaades Ll vw ‘Hernand Chief Executive Officer Sincerely, ‘ce: LaRuby Z. May, Chair, Board of Directors Maribel Torres, EVP, Patient Care Services, CNO