Headlines April
Board of Directors of Flevo Hospital allowed ICU problems to persist for years'.
The Flevo Hospital's Board of Directors has perpetuated the problems in the Intensive Care department for years. This is evident from an investigation by the radio program Argos of HUMAN and VPRO. The first signs that things were not going well in the ICU were already there in 2016. Yet the Board of Directors did not or hardly intervene. The death of at least one patient would be the result of this. Several times, ICU employees sounded the alarm about the problems and unsafe work situation in the ICU. At one point there were eight pages of complaints and incidents on the table of the Board of Directors. It was no secret that things were going badly wrong in the ICU. At the same time, the Executive Board decided to invite Mayor Franc Weerwind of Almere, to show how well everything was going in the Flevo Hospital. The hospital even made a promotional video of the visit for YouTube.
We are going to kill this patient'
According to the programme Argos, they spoke to various (former) employees of the Intensive Care. They gave an insight into how things work in the ICU. Two intensivists and a team leader were specifically singled out. They are said to be responsible for a sour working atmosphere and unsafe working environment. They were said to have exhibited transgressive behavior and a lack of professionalism in their work. One of the two intensivists is said to terrorize the staff. "Remember, I'm watching you. You'll get a bad review. I'll make sure you lose your job. If you have blond hair and a ponytail, nothing can happen to you," one staff member was allegedly told. Prior to a shift, an intensivist allegedly said, "I'm on duty this weekend, we're going to kill this patient." In another case, a corpulent patient would have been described as "a manatee" and would have been told "I'll throw a head of lettuce in there later. The ICU ward itself would be described by the doctors as "the stables.
Interim manager had to clean up
Eventually the hospital decided to appoint an interim manager in the IC department. This one initially seems to be proceeding energetically and the staff expresses confidence. This temporary intensivist also comes to the conclusion that the problems are major and are partly caused by the two intensivists.
She finally produced a 70-page report in which she concluded that the quality of care was seriously deficient and that the IC department was seriously dysfunctional. Moreover, the level of knowledge is said to be low. Physician assistants teach each other medical procedures, without supervision.
IC would have to close down, but remains open
In addition to the disturbed working atmosphere, the interim manager emphatically referred to patient safety. In her opinion, patient safety is at stake. The Flevo Hospital IC does not appear to meet the most basic quality standards. There is no daily Multi Disciplinary Consultation (consultation between different doctors and nurses about patients) and treatments are not coordinated or discussed. Intensivists pursue their own treatment policies. As an example, a case is described where one intensivist decides not to treat a patient any more (and thus to let him die in a controlled way), after which another intensivist on the next shift decides to do everything possible to keep the patient alive. Their own guidelines and standards are not being followed in the process.
All in all, the interim manager concluded that it was irresponsible to keep the ICU open and that the department should be closed. The Executive Board decides otherwise and keeps the ICU open. According to the investigators, the fact that the Netherlands was in the middle of a coronary pandemic played a role. Closing the Flevo Hospital IC unit would mean the loss of at least 17 IC beds and that is too much for the Executive Board. The IC department will therefore remain open.
Intensivists on duty refuse to come
Despite the clear conclusions of the interim manager, the Executive Board decides not to tackle the two intensivists. As a result, the work atmosphere remains sick and patient care is far from optimal. This is evident from examples where assistant physicians ask the intensivist on duty to come to the hospital in vain. It is an open secret within the hospital that intensivists on duty are virtually impossible to get to the hospital. This leads to inexperienced physician assistants having to perform medical procedures for which they do not have the knowledge and skills. For example, there is an example where a patient was pricked up to twenty times because the physician assistant could not manage to apply a central line. The intensivist on duty was called several times to assist, but refused each time.
Patient possibly died unnecessarily
Finally, the interim manager points to the working methods and work pressure within the hospital. The Flevo Hospital, for example, has chosen to have assistant physicians work double shifts. As a result, one person is responsible for both the ICU and the cardiac monitoring. According to the interim manager, this creates too high a workload and there is also no backup available if there is an emergency in both departments.
The death of at least one patient is said to be the result of this. The patient in question was a woman who was admitted with heart problems. Because the assistant physician was busy in one department, it took three hours before he could see the woman and she received an infusion. Around 8 p.m., the physician assistant calls the cardiologist because he does not trust it. The cardiologist does not think it is necessary to come to the hospital and reassures the physician assistant. Two hours later the woman's heart suddenly stops and she dies. An evaluation by the hospital itself shows that the workload of the assistant physician was far too high. The man had only been employed for two months, had little experience, was not training for a specialty and was working a double shift. His workday had already started at 2 p.m. in the afternoon. Despite the findings, the way things worked remained in place.
Things changed, but not followed through
Since the interim manager's report was issued, much has improved within the hospital, say the staff members quoted in the broadcast. One of the two intensivists who were allegedly responsible for the abuses has since left. The second is following a kind of 'social apprenticeship' in another hospital. A mediation process is also underway to see if he can return to Flevo Hospital. This is not enough for the employees of the IC; they have terminated their confidence in the Executive Board. What plays a part in this is that the interim manager has given back her assignment prematurely. According to her, this was because the Executive Board did not want to take action: the two intensivists and the team leader should have been put on hold. The Executive Board did not consider this necessary. The hospital has now appointed a new interim manager to solve the problems. The employees no longer have confidence in this.
Hospital shocked by radio program
Chair Anita Arts of the Executive Board of the Flevo Hospital says in response that she is very shocked by the radio program. She finds it very regrettable that some members of the hospital staff were rude to patients. "I find that very hurtful and disrespectful," says Arts. She wants to apologize to patients for that. "We don't want that kind of language here." According to Arts, there is no question that the hospital did nothing with the criticism. "From the moment the criticism of the IC department was known to the Board of Directors, we took immediate action. We ordered an investigation into the situation. We informed the Health Care Inspectorate from the beginning. And we shared the progress transparently. And the Inspectorate expressed confidence in our approach." Doctor states that the hospital has taken to heart the criticism that intensivists were difficult for physician assistants and ICU nurses to reach. "That doctor now sleeps in the hospital when he or she is on duty," says Arts. Intensivists would therefore always be able to intervene quickly in emergencies.
Arts believes that the radio program "brought all the nasty incidents together." According to the board chairman, those incidents in no way say that the quality of care in the ICU has been compromised. "What's going on now is that one of the two intensivists who went through an improvement program at another hospital went through that program. And now the question is; can he return to the department? That apparently creates so much tension that people felt compelled to bring something out." Physician says the hospital has brought in a mediator to see if it is possible for the intensivist to return. "That process has just started. The functioning of the department is paramount. And he knows that too," says Anita Arts.
Source: https://www.omroepflevoland.nl/nieuws/279958/raad-van-bestuur-flevoziekenhuis-liet-problemen-ic-jarenlang-voortduren
Dutch Railways: due to technical failure no more trains today
Due to a major technical failure at the NS, there will be no more trains running tonight and tonight. The failure has now been resolved but due to the aftermath it is not possible to restart train traffic, the transport company announces. "Although the cause of the disruption has now been resolved, the impact is great. To start up reliably, systems need to be updated and trains need to be brought to the right place," the NS writes in a press release. Trains are expected to resume running tomorrow. The affected system makes schedules for trains and staff. "This system is important to run safely and according to the timetable: when there is an incident somewhere, the system adapts itself accordingly," explains the NS. According to the NS, the stations in the Netherlands are reasonably quiet and are not full of stranded passengers. "In some places people are still waiting, such as in Amsterdam and at Schiphol Airport," says a spokesperson. "The advice to them is to find alternative transportation. We understand that this is very annoying, and we apologize for this." The NS says it is "thoroughly investigating" the problems. They are also looking at how the carrier can prevent this problem in the future.
Incorrect travel advice
Due to the malfunction, the travel planner showed many incorrect travel advice today. It was also not possible to show current travel information at stations for hours. The information at the stations has now been restored, the NS announced. The malfunction in the computer systems began around 12:00. The NS expected the problems to be resolved around 17.00, but later this was adjusted to 20.00. The problems were expected to be resolved after 17.00. After dinner time the message came out that train traffic is no longer possible today.
Source: https://nos.nl/artikel/2423715-ns-zeker-tot-17-00-uur-geen-treinen-door-technische-storing
Major outage at NS occurred partly due to failed backup system
The major failure that the NS suffered on Sunday was partly caused by a failing backup system. That's what State Secretary Vivianne Heijnen (Infrastructure) wrote in a letter to the House of Representatives on Tuesday. As a result of the failure, the train operator's planning system did not work. The NS therefore no longer had an overview of where trains and staff were located, a spokesperson told NU.nl on Monday. Normally, the NS can fall back on a backup system in situations like this. Why that didn't work on Sunday will be "thoroughly investigated", according to the State Secretary. The NS found it not responsible to continue working without the system on Sunday. "We could no longer guarantee the safety of passengers," a spokesperson said earlier.
According to unions, it could have been done. Henri Janssen, director of FNV Spoor, said that train drivers would also be able to see from signals whether they could drive safely. Due to the disruption, no NS trains were running from 12:00 on Sunday. After a few hours the problems were solved. However, because many trains and staff were still in the wrong places, train traffic could not be resumed until Monday morning.
"In view of the long-term and national impact of this disruption, and in view of the extent to which an appeal was made to the passenger's self-sufficiency, I consider NS' performance in this matter to be below par," writes Heijnen in the letter.
Source: https://www.nu.nl/tech/6193374/grote-storing-bij-ns-ontstond-mede-door-falend-back-upsysteem.html
Isala malfunction: emergency patients Meppel to other hospitals
Hospital organization Isala is consulting with other hospitals about admitting emergency patients who would normally go to Meppel. The reason for this is the ICT malfunction in the hospital in Zwolle. Due to a malfunction in the ICT network, the Isala hospital in Zwolle has temporarily closed the emergency room and the first aid room. Ambulances no longer drive to Zwolle, patients are taken to Drenthe hospitals, among others. "Ambulances that normally drive to Zwolle, can now also go to Isala Meppel," a spokesperson for the hospital organization announced. To prevent Meppel from filling up from two sides, regional ambulance transport has been asked to take patients north of Meppel to other hospitals. "Then you can think of Hoogeveen and Heerenveen," says the spokesperson. "Depending on where the patient is, there can be a consideration of which hospital to go to."
Tonight
According to the spokesperson, things are moving in the right direction in solving the problem. The operating rooms are slowly being restarted. "But we can no longer complete the entire program," the hospital reports. "Some of the elective patients, i.e. non-emergency patients, we therefore unfortunately have to cancel." Measures have been taken for the evening. "For example, we ask employees to work extra or longer," reports Isala. "And we are looking at whether it might be necessary to move patients to another hospital."
Operations
The outage began this morning. "This morning's operations have been completed, but now the operation program is further stopped for a while. Emergency surgeries do continue, as do outpatient appointments," Isala reported. "Patient safety has never been an issue in the hospital," the hospital writes on its own site.
Source: https://www.rtvdrenthe.nl/nieuws/14570828/storing-bij-isala-zwolle-patienten-naar-andere-ziekenhuizen
Travel agents fear million-dollar damage due to problems at Schiphol
Travel companies fear millions of euros in damages due to the problems with crowding at Schiphol. The airport has asked airlines to cancel bookings this weekend and not accept new bookings for next week. "It's one big chaos," said chairman Frank Oostdam of industry association ANVR. It is not yet clear whether airlines will indeed cancel bookings this weekend, but the fear of this alone will lead to extra work and costs for travel organizations. The costs are caused by booked accommodations remaining empty due to cancelled air travel. "The accommodations will say it's not their problem that the customer doesn't come," says Oostdam. According to him, the "fiercely frustrated and angry" travel companies are going to try to recover the damage from Schiphol. "We don't have the solution either, but we didn't cause this problem either."
Because of these actions, the trust in Schiphol is decreasing and this can also have an impact on the number of bookings with travel companies. "The damage is much greater than we can imagine," says the ANVR president. If the problems persist, he says, it could run into the tens of millions of euros.
"Our companies are facing enormous costs," says Oostdam. "As a result of the strike of KLM personnel last weekend, we have received a boom in calls from worried people who are about to go on vacation. More workers need to be deployed at call centers."
Source: https://www.nu.nl/economie/6197912/reisorganisaties-vrezen-miljoenenschade-door-problemen-op-schiphol.html
The Flevo Hospital's Board of Directors has perpetuated the problems in the Intensive Care department for years. This is evident from an investigation by the radio program Argos of HUMAN and VPRO. The first signs that things were not going well in the ICU were already there in 2016. Yet the Board of Directors did not or hardly intervene. The death of at least one patient would be the result of this. Several times, ICU employees sounded the alarm about the problems and unsafe work situation in the ICU. At one point there were eight pages of complaints and incidents on the table of the Board of Directors. It was no secret that things were going badly wrong in the ICU. At the same time, the Executive Board decided to invite Mayor Franc Weerwind of Almere, to show how well everything was going in the Flevo Hospital. The hospital even made a promotional video of the visit for YouTube.
We are going to kill this patient'
According to the programme Argos, they spoke to various (former) employees of the Intensive Care. They gave an insight into how things work in the ICU. Two intensivists and a team leader were specifically singled out. They are said to be responsible for a sour working atmosphere and unsafe working environment. They were said to have exhibited transgressive behavior and a lack of professionalism in their work. One of the two intensivists is said to terrorize the staff. "Remember, I'm watching you. You'll get a bad review. I'll make sure you lose your job. If you have blond hair and a ponytail, nothing can happen to you," one staff member was allegedly told. Prior to a shift, an intensivist allegedly said, "I'm on duty this weekend, we're going to kill this patient." In another case, a corpulent patient would have been described as "a manatee" and would have been told "I'll throw a head of lettuce in there later. The ICU ward itself would be described by the doctors as "the stables.
Interim manager had to clean up
Eventually the hospital decided to appoint an interim manager in the IC department. This one initially seems to be proceeding energetically and the staff expresses confidence. This temporary intensivist also comes to the conclusion that the problems are major and are partly caused by the two intensivists.
She finally produced a 70-page report in which she concluded that the quality of care was seriously deficient and that the IC department was seriously dysfunctional. Moreover, the level of knowledge is said to be low. Physician assistants teach each other medical procedures, without supervision.
IC would have to close down, but remains open
In addition to the disturbed working atmosphere, the interim manager emphatically referred to patient safety. In her opinion, patient safety is at stake. The Flevo Hospital IC does not appear to meet the most basic quality standards. There is no daily Multi Disciplinary Consultation (consultation between different doctors and nurses about patients) and treatments are not coordinated or discussed. Intensivists pursue their own treatment policies. As an example, a case is described where one intensivist decides not to treat a patient any more (and thus to let him die in a controlled way), after which another intensivist on the next shift decides to do everything possible to keep the patient alive. Their own guidelines and standards are not being followed in the process.
All in all, the interim manager concluded that it was irresponsible to keep the ICU open and that the department should be closed. The Executive Board decides otherwise and keeps the ICU open. According to the investigators, the fact that the Netherlands was in the middle of a coronary pandemic played a role. Closing the Flevo Hospital IC unit would mean the loss of at least 17 IC beds and that is too much for the Executive Board. The IC department will therefore remain open.
Intensivists on duty refuse to come
Despite the clear conclusions of the interim manager, the Executive Board decides not to tackle the two intensivists. As a result, the work atmosphere remains sick and patient care is far from optimal. This is evident from examples where assistant physicians ask the intensivist on duty to come to the hospital in vain. It is an open secret within the hospital that intensivists on duty are virtually impossible to get to the hospital. This leads to inexperienced physician assistants having to perform medical procedures for which they do not have the knowledge and skills. For example, there is an example where a patient was pricked up to twenty times because the physician assistant could not manage to apply a central line. The intensivist on duty was called several times to assist, but refused each time.
Patient possibly died unnecessarily
Finally, the interim manager points to the working methods and work pressure within the hospital. The Flevo Hospital, for example, has chosen to have assistant physicians work double shifts. As a result, one person is responsible for both the ICU and the cardiac monitoring. According to the interim manager, this creates too high a workload and there is also no backup available if there is an emergency in both departments.
The death of at least one patient is said to be the result of this. The patient in question was a woman who was admitted with heart problems. Because the assistant physician was busy in one department, it took three hours before he could see the woman and she received an infusion. Around 8 p.m., the physician assistant calls the cardiologist because he does not trust it. The cardiologist does not think it is necessary to come to the hospital and reassures the physician assistant. Two hours later the woman's heart suddenly stops and she dies. An evaluation by the hospital itself shows that the workload of the assistant physician was far too high. The man had only been employed for two months, had little experience, was not training for a specialty and was working a double shift. His workday had already started at 2 p.m. in the afternoon. Despite the findings, the way things worked remained in place.
Things changed, but not followed through
Since the interim manager's report was issued, much has improved within the hospital, say the staff members quoted in the broadcast. One of the two intensivists who were allegedly responsible for the abuses has since left. The second is following a kind of 'social apprenticeship' in another hospital. A mediation process is also underway to see if he can return to Flevo Hospital. This is not enough for the employees of the IC; they have terminated their confidence in the Executive Board. What plays a part in this is that the interim manager has given back her assignment prematurely. According to her, this was because the Executive Board did not want to take action: the two intensivists and the team leader should have been put on hold. The Executive Board did not consider this necessary. The hospital has now appointed a new interim manager to solve the problems. The employees no longer have confidence in this.
Hospital shocked by radio program
Chair Anita Arts of the Executive Board of the Flevo Hospital says in response that she is very shocked by the radio program. She finds it very regrettable that some members of the hospital staff were rude to patients. "I find that very hurtful and disrespectful," says Arts. She wants to apologize to patients for that. "We don't want that kind of language here." According to Arts, there is no question that the hospital did nothing with the criticism. "From the moment the criticism of the IC department was known to the Board of Directors, we took immediate action. We ordered an investigation into the situation. We informed the Health Care Inspectorate from the beginning. And we shared the progress transparently. And the Inspectorate expressed confidence in our approach." Doctor states that the hospital has taken to heart the criticism that intensivists were difficult for physician assistants and ICU nurses to reach. "That doctor now sleeps in the hospital when he or she is on duty," says Arts. Intensivists would therefore always be able to intervene quickly in emergencies.
Arts believes that the radio program "brought all the nasty incidents together." According to the board chairman, those incidents in no way say that the quality of care in the ICU has been compromised. "What's going on now is that one of the two intensivists who went through an improvement program at another hospital went through that program. And now the question is; can he return to the department? That apparently creates so much tension that people felt compelled to bring something out." Physician says the hospital has brought in a mediator to see if it is possible for the intensivist to return. "That process has just started. The functioning of the department is paramount. And he knows that too," says Anita Arts.
Source: https://www.omroepflevoland.nl/nieuws/279958/raad-van-bestuur-flevoziekenhuis-liet-problemen-ic-jarenlang-voortduren
Dutch Railways: due to technical failure no more trains today
Due to a major technical failure at the NS, there will be no more trains running tonight and tonight. The failure has now been resolved but due to the aftermath it is not possible to restart train traffic, the transport company announces. "Although the cause of the disruption has now been resolved, the impact is great. To start up reliably, systems need to be updated and trains need to be brought to the right place," the NS writes in a press release. Trains are expected to resume running tomorrow. The affected system makes schedules for trains and staff. "This system is important to run safely and according to the timetable: when there is an incident somewhere, the system adapts itself accordingly," explains the NS. According to the NS, the stations in the Netherlands are reasonably quiet and are not full of stranded passengers. "In some places people are still waiting, such as in Amsterdam and at Schiphol Airport," says a spokesperson. "The advice to them is to find alternative transportation. We understand that this is very annoying, and we apologize for this." The NS says it is "thoroughly investigating" the problems. They are also looking at how the carrier can prevent this problem in the future.
Incorrect travel advice
Due to the malfunction, the travel planner showed many incorrect travel advice today. It was also not possible to show current travel information at stations for hours. The information at the stations has now been restored, the NS announced. The malfunction in the computer systems began around 12:00. The NS expected the problems to be resolved around 17.00, but later this was adjusted to 20.00. The problems were expected to be resolved after 17.00. After dinner time the message came out that train traffic is no longer possible today.
Source: https://nos.nl/artikel/2423715-ns-zeker-tot-17-00-uur-geen-treinen-door-technische-storing
Major outage at NS occurred partly due to failed backup system
The major failure that the NS suffered on Sunday was partly caused by a failing backup system. That's what State Secretary Vivianne Heijnen (Infrastructure) wrote in a letter to the House of Representatives on Tuesday. As a result of the failure, the train operator's planning system did not work. The NS therefore no longer had an overview of where trains and staff were located, a spokesperson told NU.nl on Monday. Normally, the NS can fall back on a backup system in situations like this. Why that didn't work on Sunday will be "thoroughly investigated", according to the State Secretary. The NS found it not responsible to continue working without the system on Sunday. "We could no longer guarantee the safety of passengers," a spokesperson said earlier.
According to unions, it could have been done. Henri Janssen, director of FNV Spoor, said that train drivers would also be able to see from signals whether they could drive safely. Due to the disruption, no NS trains were running from 12:00 on Sunday. After a few hours the problems were solved. However, because many trains and staff were still in the wrong places, train traffic could not be resumed until Monday morning.
"In view of the long-term and national impact of this disruption, and in view of the extent to which an appeal was made to the passenger's self-sufficiency, I consider NS' performance in this matter to be below par," writes Heijnen in the letter.
Source: https://www.nu.nl/tech/6193374/grote-storing-bij-ns-ontstond-mede-door-falend-back-upsysteem.html
Isala malfunction: emergency patients Meppel to other hospitals
Hospital organization Isala is consulting with other hospitals about admitting emergency patients who would normally go to Meppel. The reason for this is the ICT malfunction in the hospital in Zwolle. Due to a malfunction in the ICT network, the Isala hospital in Zwolle has temporarily closed the emergency room and the first aid room. Ambulances no longer drive to Zwolle, patients are taken to Drenthe hospitals, among others. "Ambulances that normally drive to Zwolle, can now also go to Isala Meppel," a spokesperson for the hospital organization announced. To prevent Meppel from filling up from two sides, regional ambulance transport has been asked to take patients north of Meppel to other hospitals. "Then you can think of Hoogeveen and Heerenveen," says the spokesperson. "Depending on where the patient is, there can be a consideration of which hospital to go to."
Tonight
According to the spokesperson, things are moving in the right direction in solving the problem. The operating rooms are slowly being restarted. "But we can no longer complete the entire program," the hospital reports. "Some of the elective patients, i.e. non-emergency patients, we therefore unfortunately have to cancel." Measures have been taken for the evening. "For example, we ask employees to work extra or longer," reports Isala. "And we are looking at whether it might be necessary to move patients to another hospital."
Operations
The outage began this morning. "This morning's operations have been completed, but now the operation program is further stopped for a while. Emergency surgeries do continue, as do outpatient appointments," Isala reported. "Patient safety has never been an issue in the hospital," the hospital writes on its own site.
Source: https://www.rtvdrenthe.nl/nieuws/14570828/storing-bij-isala-zwolle-patienten-naar-andere-ziekenhuizen
Travel agents fear million-dollar damage due to problems at Schiphol
Travel companies fear millions of euros in damages due to the problems with crowding at Schiphol. The airport has asked airlines to cancel bookings this weekend and not accept new bookings for next week. "It's one big chaos," said chairman Frank Oostdam of industry association ANVR. It is not yet clear whether airlines will indeed cancel bookings this weekend, but the fear of this alone will lead to extra work and costs for travel organizations. The costs are caused by booked accommodations remaining empty due to cancelled air travel. "The accommodations will say it's not their problem that the customer doesn't come," says Oostdam. According to him, the "fiercely frustrated and angry" travel companies are going to try to recover the damage from Schiphol. "We don't have the solution either, but we didn't cause this problem either."
Because of these actions, the trust in Schiphol is decreasing and this can also have an impact on the number of bookings with travel companies. "The damage is much greater than we can imagine," says the ANVR president. If the problems persist, he says, it could run into the tens of millions of euros.
"Our companies are facing enormous costs," says Oostdam. "As a result of the strike of KLM personnel last weekend, we have received a boom in calls from worried people who are about to go on vacation. More workers need to be deployed at call centers."
Source: https://www.nu.nl/economie/6197912/reisorganisaties-vrezen-miljoenenschade-door-problemen-op-schiphol.html
Translated from Dutch to English with Google translate