Los Angeles County Board of Supervisors Critical of Consulting Firm’s Performance at King/Drew Medical Center
The five members of the Los Angeles County Board of Supervisors have "expressed dissatisfaction" with the performance of the consulting firm Camden Group at Martin Luther King Jr./Drew Medical Center in Los Angeles in part because problems with the nurse staff persisted at the facility after the firm was hired to address lapses in patient care, the Los Angeles Times reports.
Officials in December 2003 contracted with Camden to verify nurses' competency, develop plans to improve the quality of care and fill vacant positions. Navigant Consulting in November 2004 replaced Camden.
Before Navigant assumed control, Camden said it had trained nursing managers on how to more effectively discipline nurses and trained more than 300 employees on how to properly manage aggressive patients. Camden also said that it had verified all nursing staff's life-support credentials.
Barbara Patton, Camden's senior vice president of hospital operations, said that the firm added 100 temporary nurses to fill nursing vacancies and began writing policies and procedures for nursing responsibilities.
However, Navigant auditors in a report released in January found that nurses continued to lack necessary skills, managers found it difficult "to hold staff accountable" and at least 15% of registered nurses in the emergency department had expired life-support credentials.
Patton said that some King/Drew nurses resisted Camden's recommendations because some nurses wanted to maintain current operating procedures, the Times reports. Patton said that some nurses denied receiving new patient care policies and would not implement new patient care procedures after being retrained, according to Patton.
Patton said, "We haven't worked harder at any other engagement in our lives. You couldn't underestimate how aberrant some of the situations are in that organization. You walk in and you say, 'How can this be? This is nuts.'" She added, "Not every nurse at Martin Luther is deplorable. They've got good nurses there. They're just not in the majority or they leave or they quit."
County Department of Health Services Director Thomas Garthwaite said the health department should have committed more resources earlier to address problems at King/Drew. "I don't think it's fair to say that [Camden] didn't do a lot of work. They did do a lot of work. It's like you peel back one board on your house and suddenly you've got termites everywhere. On the outside it looked like a perfectly good house," Garthwaite said.
Supervisor Gloria Molina at a January board meeting said, "We paid them all this money. We trusted them. And we came back with nothing."
Supervisor Zev Yaroslavsky said, "I think Camden owes the county an explanation, and if it's not a good enough explanation, we'll take it one step at a time." He said that the county could take action against the firm, according to the Times (Ornstein, Los Angeles Times, 2/14).
Los Angeles County should "immediately ... establish a rigorous and professionally oriented body at King/Drew itself" because creating a countywide health authority "requires state legislation, enactment of which can take a year or more," Yaroslavsky writes in a Times letter to the editor. Yaroslavsky adds that an oversight body at King/Drew would help "bridge the informational and accountability gap between the hospital administration itself and the policymakers and health department executives who must oversee its operation" within the county health care system.
He concludes, "Our goal must be to turn King/Drew around and transform it into the center of medical excellence our clients deserve" (Yaroslavsky, Los Angeles Times, 2/15).