Four Los Angeles County Hospitals Receive Surprise JCAHO Inspections

Reviewers from the Joint Commission on Accreditation of Healthcare Organizations on Monday began unannounced inspections at four Los Angeles County hospitals, signaling that the agency, which has threatened to rescind its accreditation for Martin Luther King Jr./Drew Medical Center because of repeated patient care violations, "wants to assess the quality of care at other public hospitals overseen by the county Board of Supervisors," the Los Angeles Times reports. JCAHO inspectors will examine patient charts and other aspects of care at County-USC Medical Center in Boyle Heights, Harbor-UCLA Medical Center near Torrance, Olive View-UCLA Medical Center in Sylmar and Rancho Los Amigos National Rehabilitation Center in Downey. King/Drew also will be reinspected, although JCAHO officials visited the hospital last week in response to a patient death.

County Department of Health Services Director Thomas Garthwaite, who invited the JCAHO reviewers, said he hopes the reviews "assure the public that the things found at King/Drew are not rampant, are not a problem at our other facilities." He added, "I don't think that fair, honest inspection is anything but helpful to improve the quality of our care" (Ornstein, Los Angeles Times, 10/19). The inspections are expected to be finished Tuesday, and the results will be presented to hospital leaders as early as Wednesday (AP/Contra Costa Times, 10/19).

The inspections come just four days after JCAHO President Dennis O'Leary sent a "scathing letter" to the county board, "unequivocally blaming it for serious lapses in patient care at King/Drew," the Times reports. In the letter, which was faxed to each supervisor and sent to other local politicians, O'Leary wrote, "I wish to be clear that the responsibility for these failures -- whose effect has been to place a uniquely vulnerable patient population in harm's way -- by definition lies with the County of Los Angeles Board of Supervisors."

O'Leary added, "It is just as clear that the responsibility, and indeed the opportunity, to restore the reputation and the reality of King/Drew Medical Center as a trusted, respected provider of health care services in its community also belongs to the Board of Supervisors."

According to the Times, O'Leary said in an interview that "he has rarely delivered such personal rebukes to a hospital's overseers," but he did so in this case to increase the likelihood of "decisive actions."

O'Leary also said he supports the board's plan to close King/Drew's trauma center because the hospital "has limited capabilities in providing basic care." He added, "It should divert the most demanding cases to other hospitals in its community until it's able to provide basic care and then rebuild its trauma capability. This is a temporary, very rational step to buy time for investing in basic improvements." O'Leary said those who have protested the trauma center's closure have created a "very politically charged atmosphere with accusations of racism and everything else imaginable. Those have nothing to do with anything, in my opinion. I'm sure that the people who are rallying and putting up Web sites are all well intended, but they are not behaving as part of the solution."

Supervisor Gloria Molina said she understands the message in JCAHO's letter, adding, "At the end of the day, we're the ones that are responsible."

Supervisor Zev Yaroslavsky said, "There's plenty of blame to go around, and the board certainly deserves its share."

Supervisor Yvonne Brathwaite Burke, whose district includes King/Drew, noted that county health officials and outside contractors for the hospital also are to blame for the state of the facility and its lack of improvement in patient care over the past year. She said, "I'm very disappointed that the people we put there have not accomplished anything. It's hardly a pleasant situation. It's a crisis-ridden situation, and we're trying to correct it and move forward."

Assembly member Mervyn Dymally (D-Compton), who has opposed closing the trauma center, said he is disappointed by O'Leary's support of the board's plan. "Those of us who hold public office have been criticized for posturing, but I don't know what else one can do," Dymally said, adding, "If you represent a community in distress, your responsibility is to represent the community. I think we've been very constructive in our approach" (Los Angeles Times, 10/19).