Safety is top goal of makeover at state hospital

Nurse manager Robert Burns navigates his way through the pale hallways of the Hawaii State Hospital in Kaneohe with a partially blinded left eye from being injured twice in the same area during assaults while working with psychiatric patients.

Burns, who wears dark glasses indoors because his eyes are now sensitive to light due to his injuries, has been assaulted an estimated 50 times in the nearly 19 years he’s worked at the state’s only public adult psychiatric hospital for serious mental illness.

The building Burns works in was built in the 1950s with a nurses’ station behind a plexiglass wall. Staff at the station can see only a portion of the psychiatric ward he manages, while another hallway and common areas are blind spots where workers like Burns frequently get into trouble when a patient becomes violent.

A new 144-bed hospital building currently under construction is designed to minimize blind spots with hallways and corridors in the line of sight of the nurses stations and digital cameras installed throughout the facility.

“It’s a dangerous job so I was in the cross hairs so to speak. I’m really looking forward to getting into that building because it will be much safer for us,” said Burns, who has worked at the hospital since 2000.

Construction of the new building began in August and is slated to be completed by the end of 2020. Patients are expected to be relocated by October 2021. This week hospital officials gave a tour of the new facility to the Honolulu Star- Advertiser.

The new hospital will house the most dangerous, high-risk patients.

“The most important piece is being able to separate patients and give them the treatment they need,” said Run Heidelberg, the hospital’s new administrator. “This will allow us to better categorize patients in the settings that they actually need to be in. Then we can actually have a con­tinuum of care. People can work their way to the community and that is the most important piece — being able to separate patients and give them the treatment they need.”

Lawmakers granted the Health Department, which oversees the hospital, $160.5 million for the project that will include a new security system with secure entry and exits, a central security station that will be manned 24 hours a day, as well as a highly secure outdoor yard with no-climb fencing.

The existing hospital has five buildings with seven wards varying in levels of psychiatric care.

Built with a 178-bed capacity, the hospital now routinely exceeds its 202 licensed beds in buildings so old that they often can’t handle 21st century surveillance systems. For at least a year since August 2018, parts of the 25-year-old surveillance system in the hospital weren’t operational. Last week the Department of Health installed the final digital hub that will connect all the cameras throughout the campus. The department planned to install more than 300 new cameras and other digital equipment at a cost of about $560,000, replacing an outdated analog system.

Hospital employees have complained for years about staffing as well as a faulty security system, which jeopardizes the safety of patients, staff and the public.

The most recent high-profile case involved escapee Randall Saito who walked off the grounds, took a taxi to the airport and boarded a chartered flight to Maui, then took a flight to San Jose, Calif., in November 2017. Saito was committed to the facility in 1981 after being acquitted of murder by reason of insanity for killing a 29-year-old woman in Ala Moana Center’s parking lot. He wasn’t reported missing until eight to 10 hours after his escape, and wasn’t captured until three days later in Stockton, Calif.

Staffing has been a significant concern with the increase in court-ordered patients at the hospital, which spent $6.6 million, or 8.6% of its $75.6 million budget in fiscal 2019 on overtime. Overworked employees often call in sick, exacerbating the shortage. There are about 60 open positions.

“It’s just this big vicious cycle with sick leave. Staffing is always a problem,” Burns said. “It’s been an issue for the last 30 years I’ve been a nurse.”

The new building will measure more than 192,000 square feet with four floors. The ground floor will have rooms for rehabilitation and occupational therapy, a gym for recreational therapy and an outdoor park within the secure building. It will also have a rehabilitation mall and other common areas for patient services, including a chapel and courtroom. The three upper floors are designated for patients and staff.

The hospital, which has more than 600 employees, plans to hire another 200, including more security officers. The facility has roughly 45 guards and is planning to increase that to as many as 80 to augment staffing in case of emergencies.

“One of our goals is community safety and really there’s no price tag on keeping the community safe,” Heidelberg said. “Patients are court ordered to be here for a reason and we want to make sure that we’re able to keep up with them … and what we’re here to do is to keep them safe.”