In The Alvear Hospital They Do Not Have Pregnancy Tests for Patients
According to the Audit of the City of Buenos Aires, the study should be routine because 90% of women admitted to the health center are able to procreate and psychiatric medication causes malformations in the fetus. On the other hand, there are irregularities in the making of patients' medical records and building deficiencies.
The General Audit of the City of Buenos Aires (AGCBA, for its acronym in Spanish) detected that in the Hospital of Psychiatric Emergencies Alvear "the pregnancy test is not performed as a routine procedure for patients of childbearing age" who enter the health center. The data, according to the Watchdog, becomes more relevant if one takes into account that 90% of interned women are between 15 and 46 years old, and that psychiatric medication has teratogenic effects, that is, they produce malformations in fetuses.
Another of the irregularities found by the AGCBA is that in 40% of the analyzed clinical histories the decompensation situations of hospitalized patients were solved by residents, both doctors and psychologists. The intervention of the residents is registered with greater intensity in the shifts of the afternoon, the night, weekends and holidays. The control body is of the opinion that responsibility for decompensated patients should be shared with the physicians on duty and that both should sign the relevant documentation.
On the other hand, on the ER there is an "excessive stay of hospitalized patients". 97% of the hospital's income is by the guard and an average stay of 9 days was recorded, when it is advisable not to exceed 7.
In 22% of the medical records analyzed in the external clinics unit, the decisions and recommendations of the professionals are not recorded, which means that it is not known in those cases whether the patients attended the consultation or if they were cared for. On the other hand, although the average time for benefits should be 30 or 40 minutes in external clinics, it was found that each consultation lasts almost two hours on average and, therefore, the control body says that the productivity of the "Professional hours" is "low". In addition, not all physicians submit daily activity records or specify dates of care or schedules. During the months of Audit study, the professionals who did not comply with these steps were always the same and, however, "no attention was registered" by their superiors.
"There is difficulty in referring patients to the Day Hospital and other centers," the report says. This modality is used to care for those who do not need to sleep in the health center and who treat their ailments during the day. Waiting times for referrals are "around 30 days" and, according to AGCBA, during this period patients continue in the rooms "despite being able to be discharged." Also, the time of stay in the Day Hospital is 8 months, on average. About this, the control body explains that the admission to this service is a "scarce and necessary" resource, and that "the lack of vacancies to incorporate new patients generates, on many occasions, the delay in the expenses of Alvear's hospitalization rooms."
Regarding health, the report says that the Hospital "does not have the basic resources to guarantee hygienic conditions and adequate infection barrier", and that both the hospital staff and the outsourced company in charge "do not know cleaning and handling techniques of pathogenic waste."
Regarding the building condition of the Alvear Hospital, the AGCBA observed that "there is no preventive maintenance of the installations and corrective maintenance is not executed in a timely manner". The Hospital has ample spaces to make recreational outings, but the state of abandonment of the property makes the percentage of patients who perform these activities exceeds only 30%, and there is only one that works in the garden workshop.
The Audit also discovered administrative shortcomings. For example, 12% of the analyzed clinical histories found differences between the identifiable code of the assigned disorder (the alphanumeric key that the administrative staff leaves in the medical records), and the one written by the professional. And, even though half of the patients perform music therapy, the costs were not covered after the professional's death.