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Consultants find that cultural problems at LA hospital may cost millions to fix

Patient Safety Monitor Alert, January 7, 2005

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Fixing the problems at Martin Luther King Jr./Drew Medical Center in Los Angeles will likely take more than a year and cost more than the millions of dollars that Los Angeles County has committed, officials told the Los Angeles Times.

Navigant Consulting, which has a one year, $13.2 million contract at the hospital, prepared a report that consists of almost 1,000 recommendations for change. The consultants suggested that the problems could not be resolved as long as the hospital's Board of Supervisors remains in charge. Instead, they suggest creating a separate hospital authority, a system used in other metropolitan areas to protect hospitals from political interference.

The consultants found that the hospital's culture has bred many of the problems, as management doesn't demand accountability and staff do not always take responsibility for doing jobs properly. They found inadequate performance reviews of physicians and an ineffective disciplinary system. According to the report, surgical staff don't always wear masks or sterilize operating room instruments. Some staff could not competently respond to a "Code Blue" emergency call, either not showing up or not knowing what to do upon arrival.

Among other problems, the consultants found:

• many nurses lack proper credentials
• operating room staff failed to consistently remove sponges and other instruments from patients
• patient rooms in psychiatric units were unsafe, as removable closet doors can be used as weapons in some cases
• no process for reporting unusual deaths of patients and finding out whether doctors or nurses' mistakes contributed to the deaths
• nurses failed to report medication errors consistently

To read the Los Angeles Times article, click here.

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