The situation at the King/ Drew Medical Center in Los Angeles continues to spiral downwards. We had previously posted (here and here) about the ongoing troubles at the medical center. Long viewed as a symbol of progress for poor and minority patients in the city, it had fallen on very hard times, attributed to bad management that for a long time hid behind the banner of the hospital's reputation in the community.
Last week, the Los Angeles Times reported that the medical center had failed a key medical inspection, and is threatened with loss of all its Medicare and Medicaid payments at the end of the year. "During the latest inspection, the hospital failed nine of the government's 23 conditions for federal funding, according to a letter from the U.S. Centers for Medicare and Medicaid Services...." One of the problems found during the latest inspection were a lack of "appropriately trained and competent" staff to attend cardiac monitors on one unit. The letter noted "This is especially troublesome, because previously documented cases showed that patients died when nurses at King/Drew failed to heed heart monitor warnings." Another article early this week repeated the entire chronology of King/Drew's problems. Today the Times reported that the most likely strategy to be used to continue to provide medical care to King/Drew's patients is to hand over operation of a down-sized facility to another Los Angeles County hospital, Harbor-UCLA Medical Center.
A few lessons from this sorry story: in health care, it is often the whole institution and its most vulnerable constituencies that suffer for the mistakes made by top managers; and that bad managers can hide for a long time behind institutions that enjoy a favorable reputation.
The board has to be on board - Those of us who have run hospitals where we've been serious about achieving improvements in quality and safety know that without a highly committed board o...
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