February 8, 2017

How Brigham and Women's bolstered protocol after fake resident accessed ORs

Daily Briefing

A former surgical resident who had been dismissed from a residency program in New York City gained unauthorized access to Brigham and Women's Hospital—including several ORs—in December 2016, although a spokesperson for the hospital said "she did not touch, treat, or provide care to a single patient."

Cheryl Wang, 42, blended in at the hospital, according to Erin McDonough, a spokesperson for Brigham. She wore scrubs with the hospital's logo, "knew her way around, understood the hospital culture and terminology, and was familiar with people's names," McDonough said.

Based on a review of security footage and other evidence, Brigham officials said Wang accessed a total of five ORs and observed several surgeries at the hospital during the week of Dec. 5, 2016, Liz Kowalczyk reports for the Boston Globe. The footage shows that Wang was able to access the ORs—which are restricted by electronic card readers—by "tailgating," or slipping in behind staff with valid IDs after they swiped in or were holding the door for other colleagues.

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Wang also attended patient rounds in thoracic surgery until Dec. 7, 2016, when she was confronted by a doctor and escorted off the property. Brigham and Women's immediately posted Wang's photo and emailed an alert to OR staff. The hospital also notified Massachusetts General Hospital (both Brigham and Mass General are part of Partners HealthCare) and Boston Children's Hospital (which is connected to Brigham) that Wang was a security risk. 

The next day, Wang tried to attend a medical staff discussion at Mass General and was apprehended. Bonnie Michelman, executive director of security at Mass General, said investigators from Mass General and Brigham interviewed Wang and "did not find anything in her background that would cause us to be extraordinarily concerned." However, the officials from the hospitals warned Wang that if she returned she would be arrested.

Immediately after the interview, investigators from Brigham's and Mass General followed Wang to Children's Hospital, where she attempted, but failed, to enter the building.

A troubled past

Mass General and Brigham officials during their investigation learned that Wang had previously been dismissed from a surgical residency program at Mount Sinai St. Luke's Hospital in New York City because she had a verbal altercation with a colleague and refused to attend counseling. St. Luke's reported her to the Office of Professional Medical Conduct in New York.

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In September, Wang applied to transfer from Mount Sinai to Brigham's residency—but she did not mention she had been dismissed from St. Luke's. She attached three recommendation letters to her application (which Mount Sinai later said were forged) and asked to shadow a surgeon at Brigham while her application was pending. The surgeon granted her request for Sept. 20 and 21, 2016. That may have been when Wang became familiar with Brigham and obtained scrubs with the hospital's logo, the Globe reports.

Brigham bolsters protocol

Brigham's strategy of restricting OR access via electronic card readers and security cameras is "best practice," according to Martin Green, president of the International Association for Healthcare Security & Safety. But tailgating remains a common problem in the industry.

Michelman said tailgating is hard to combat because people are naturally polite and want to hold the door. "We always have to teach people to go against the way they were brought up," she explained.

But following the incident, Brigham officials said the hospital intends to train staff about the dangers of tailgating. In addition, Brigham has bolstered its policy for permitting observers in the hospital's 47 ORs. Physicians who are sponsoring a student observer are now required to verify with the student's education institution that the student "is in good standing."  

McDonough, the Brigham spokesperson, said, "We know that in addition to best practice security measures, the safety and security of our hospital requires the vigilance of everyone who works here. All involved are fully committed to providing a secure [OR] for our patients and staff " (Kowalczyk, Boston Globe, 2/5; Minemyer, Fierce Healthcare, 2/6; Ellison, Becker's Hospital Review, 2/6). 

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