An investigation and peer review were launched after a complaint about the quality of care at the Kahuku Medical Center emergency room, and no adverse patient outcomes were found, according to hospital administrator Lance Segawa.

Dr. Laura Moire, who had been working as an emergency room physician at Kahuku, had raised concerns about two incidents that occurred last October before the state took charge of the financially strapped facility.

After saying that her concerns had been ignored for months by the hospital, Moire met with the new hospital administrator and a member of the hospital's board on May 30. Some of the staff in the emergency room at the Kahuku hospital have placed patients' health and safety at risk, she said.

Segawa said a letter detailing Moire's complaints was immediately investigated by hospital peers. Since this was the second time she had brought up concerns about the same two incidents, he pulled together a bigger peer group to analyze the situation.

"The physicians on the peer review group did not find any issues regarding adverse patient results," Segawa said. "They did not find anything in that area."

After years of struggling financially, the Kahuku hospital was acquired by the Hawaii Health Systems Corp., the quasi-government body that runs most of the state's rural hospitals. The acquisition was completed in March.

The HHSC infused the hospital with $6 million to sustain operations, much to the relief of the surrounding community that had rallied legislators and the governor to keep the hospital, and especially the emergency room, open. The next closest hospital emergency rooms are in Wahiawa and Kailua.

Segawa said he could not discuss the details of the complaints but said patients are receiving proper care in the emergency room.

"I do feel confident (in) and I take seriously the physicians involved in that peer review process," he said.

Segawa said he has initiated a new process to address problems at the hospital called root-cause analysis that looks for the cause of a problem rather than focusing on blame. It encourages participation and openness, he said.

"The focus is the underlying issue ... the things that may be making it difficult for people to do their jobs well," Segawa said.

Moire no longer works for the private contractor that supplies doctors for Kahuku hospital's emergency room, but she still can practice there.

She said she was happy with the outcome of her meeting with Segawa and hopes to continue working with the hospital and HHSC to improve services there.

"There's a lot of resources in HHSC," she said. "There's a lot of brilliant minds that will work together to make sure that Hawai'i safety net is the best it can be."

Irene Carpenter, president of the Ko'olauloa Community Health and Wellness Center in Kahuku, praised Segawa's efforts since taking over the administration of the hospital in March, especially involving staff and the community in making decisions about the facility.

"I would be really, really happy to see that kind of input from the staff and the community continue because it was lacking for many years," Carpenter said.