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Wednesday, April 13, 2005

King/Drew, Again: Putting Symbols Ahead of Patient Care?

The Martin Luther King Jr/ Drew Medical Center in Los Angeles is back in the news again, unfortunately for all the wrong reasons. The Los Angeles Times major investigative series on the troubles at the hospital suggested many of them appeared attributable to mismanagement. A local pundit had suggested that viewing the hospital as a revered political symbol (of political progress for African-Americans living in the Watts ghetto) prevented people from addressing the real failings of its very human leaders, as we mentioned in Health Care Renewal in December, 2004.
Things at King/Drew do not appear to be getting better, even after Los Angeles County hired Navigant Consulting, to use its turn-around expertise to improve hospital management. The Los Angeles Times has just reported another series of apparently avoidable patient deaths. Meanwhile, county politicians are continuing their noisy debate. For example, Supervisor Yvonne Brathwaite Burke, who represents the district in which King/Drew is located, declared, "I'll tell you this: That hospital will be closed over my dead body." Supervisor Zev Yaroslavsky countered, "The only dead bodies I'm concerned about are the dead bodies that we're seeing here."
A Los Angeles Times editorial blamed a "culture of finger-pointing and blaming." Its examples included that an anesthesologist did not respond to a "code blue" because he had never received a pager. Hospital doctors, through their lawyer, blamed Navigant, which "hasn't gotten around to distributing ... pagers." The editorial wondered "what kind of doctor would sit around and wait for someon to hand out pagers." Whatever the reason, that physicians in an urban American hospital in 2005 do not have them seems absurdly at odds with the hospital's stated mission, "To provide quality comprehensive Medical Care that is Accessible, Acceptable and Adaptable to the needs of the community we serve."
Furthermore, another Times editorial charged that the current Mayor of Los Angeles is using "the hospital born of the Watts riots ... [as] a powerful black symbol," even while he fails to "denounce the death of so many patients, most of them poor, virtually all black or Latino." Thus, the editorial charged "he is pandering to those who see King/Drew as a symbol of power, not protecting the patients who rely on its care."
Again, this is a tragic story which suggests the bad results of putting politics before the core health care mission, and of letting hospital managers hide behind the revered image of their institution, even as it crumbles around them.

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