KIPS BAY — Staff at Bellevue Hospital used restraints on patients more than any other hospital in the city and was inconsistent in the way it kept records of those incidents, according to a new report.
Patients at Bellevue were restrained 2,417 times between September 2014 and August 2015, according to data gleaned from NYC Health and Hospitals Corporation, which operates Bellevue, but the hospital, in its internal records, tallied only 1,328 incidents, according to a report by advocacy group Disability Rights New York.
Bellevue keeps track of restraint incidents by filling out restraint forms, and DRNY filed two separate Freedom of Information Law requests to Bellevue and HHC, revealing a significant discrepancy in records, the group said.
The numbers signified when staff used mechanical restraints on patients, as opposed to sedative injections. A spokeswoman for HHC declined to comment on the reason behind the discrepancy, and would not immediately say what type of mechanical restraints were used by Bellevue.
The number of restraint incidents reported by HHC showed a rate at Bellevue of 6.7 restraints per hospital bed — a higher rate than any other hospital in the city and more than two points higher than the hospital with the next-highest rate, Kings County Hospital.
And some of the incidents included prolonged periods of restraint, including one child with autism who in 2014 was restrained 36 out of the 43 days she was hospitalized, according to the findings, which were first reported by Gothamist.
State law requirese hospital staff to, when possible, limit use of restraints to last-resort, use de-escalation techniques, and refrain from restraining patients without a physician's recommendation except in an emergency. Patients' comfort and safety are supposed to be supervised and checked every 30 minutes, the law states.
A finding that the group called even more troubling is that Bellevue does not appear to be documenting its use of “chemical restraints,” or sedatives, at all.
Information released to DRNY in response to its FOIL request showed that staff at Bellevue had administered intramuscular injections on 13,216 occasions between September 2014 and August 2015, but the data made no distinction as to when the injections were used in an emergency to sedate patients, according to the report.
Bellevue is a large hospital, and is the landing site for many people whose erratic or violent behavior lands them in NYPD custody. But according to Mark Murphy, a spokesman for DRNY, the hospital's size doesn't account for its dramatically higher rate of use of restraints than other city hospitals that also have intake patients with volatile behavior.
“It’s not as if all the people who act out or are violent are all at Bellevue,” he said. “Obviously if you have a large hospital you’re going to have more individual occurrences of restraint, but the rate is higher at Bellevue, and I don’t think any evidence shows that its size is the reason for that.”
In its conclusion, DRNY suggested a list of steps the hospital can take to lessen its reliance on mechanical and chemical restraints, including improving its staff-to-patient ratio, focusing on de-escalation, and instituting better training.
The group also suggested the hospital develop a more comprehensive data collection system, in order to avoid a misrepresentation of the use of restraints.
Despite calling Bellevue's use of restraints and its lagging recordkeeping "disturbingly erratic at best" in the report, Murphy said the hospital has been receptive to DRNY's suggestions, and said a meeting is scheduled for January to look at how to improve Bellevue's use of restraints.
Evelyn Hernandez, a spokeswoman for HHC declined to comment on specifics of the report, but said in a statement that the hospital is committed to training its staff and following state regulations on use of restraints.
“NYC Health + Hospitals/Bellevue understands the need to appropriately utilize restraints and seclusion when needed — we have introduced new training protocols this year and adopted other measures to further support our efforts, with promising preliminary results," she said. “We continuously seek solutions that enable us to deliver excellent mental health and medical care to our patients and keep patients and staff safe.”
