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SMH Develops New ER Protocols to Address Early Pregnancy Loss

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Sarasota Memorial Health Care System is revising its emergency care protocols to ensure not only the best clinical care, but also the ongoing emotional support women need when experiencing early pregnancy loss.

CEO Gwen MacKenzie said the changes improve communication and collaboration between the emergency room staff and the multi-disciplinary specialists available in the hospital to help manage both the physical and psychological needs of women suffering miscarriages.

“As the only hospital in the county providing obstetrical care, caring for women through every stage of their pregnancy is a responsibility and privilege that we do not take lightly,” MacKenzie said. “Early pregnancy loss is particularly difficult because in many cases medical treatment cannot prevent it. While we may not always be able to preserve the pregnancy, we have the resources and expertise to ensure any woman who comes to us with a threatened pregnancy feels that every effort has been taken to care for her in her time of need.”

Among other changes, the new emergency room protocols include improvements in assessing and managing pain and blood loss, ensuring women have the emotional and psychological support they need, and consults with high risk labor & delivery nurses and physicians, pain care and other specialists to help manage symptoms and/or complications associated with early pregnancy loss.

Sarasota Memorial began reviewing its protocols and making changes in early July after a patient suffering a particularly difficult miscarriage wrote a letter to administrators expressing deep concerns over the care she received in the ER. Hospital quality staff reviewed and found the care lacking in several areas, including the assessment and management of the patient’s pain, emotional distress and changes in condition during her stay in the ER.

The letter, which was also forwarded to the Florida’s Agency for Health Care Administration (AHCA), prompted a survey of the hospital Aug. 8. While the state did not blame the patient’s miscarriage on the hospital, surveyors found that the hospital failed to provide adequate clinical care and psychological support to the patient. The hospital is submitting a formal plan of correction to AHCA today.

During the next several weeks, hospital staff will work with AHCA to address the issues identified in the survey and plan of correction. AHCA, on behalf of the federal Centers for Medicare & Medicaid Services (CMS), is expected to conduct another unannounced, comprehensive review of the organization sometime in the next 30-60 days to assess its compliance with CMS’ Conditions of Participation. These conditions are a set of regulatory requirements that all hospitals must meet to receive federal funding through the Medicare and Medicaid programs.

“We value AHCA’s thorough review and their recommendations for improvement,” MacKenzie said. “We want the family and community to know that this situation does not reflect the high standards of care we provide at our hospital, and we deeply regret the pain and anguish experienced by this family. We will continue working with our medical and nursing staff to ensure only the highest quality of care, safety and well being of our patients.”

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