Los Angeles County Officials Discuss Proposal To Close King/Drew Medical Center Trauma Unit
Los Angeles County Supervisor Yvonne Brathwaite Burke on Monday urged fellow supervisors to research the possible impact that closing the trauma unit at Martin Luther King Jr./Drew Medical Center could have on the community before voting on the plan Tuesday, while county Department of Health Services Director Dr. Thomas Garthwaite provided the department's "most detailed public rationale to date for the proposal," the Los Angeles Times reports (Chong/Fox, Los Angeles Times, 9/21). The county Board of Supervisors last week unanimously supported a plan to close the trauma unit and hire outside managers to run the hospital in an effort to address other problems at the hospital.
Under the plan, the trauma unit would close but King/Drew's emergency department would remain open. The trauma unit, which treats patients with life-threatening injuries from incidents such as shootings and car accidents, treats 2,150 patients annually, and the ED treats 45,000 patients annually. The proposal is subject to final approval by the board following a public hearing, which has not yet been scheduled. If the proposal is approved, King/Drew's trauma unit would close in about 90 days.
On Friday, Burke, who represents King/Drew's district, filed a motion requesting a postponement on the vote. In her statement, Burke said that "closing the trauma unit ... may not be the most appropriate response to the problems facing the hospital" and suggested there may be "other clinical areas" that could be closed instead. However, a majority of supervisors said that they remained committed to the plan to close the trauma unit (California Healthline, 9/20).
Burke on Monday maintained that the proposal was "premature and could cost some patients their lives," the Times reports. Burke said city paramedics told her the closure "might be a threat to life" because diverting patients to other hospitals would lengthen ambulance rides. She added that when the health department offered the proposal, officials failed to give supervisors complete information on issues such as whether other area hospitals could provide care for patients currently treated at King/Drew.
Although health officials hope to open a trauma unit at California Hospital Medical Center in Los Angeles, Burke said she has heard the hospital "is going to take a while to get a trauma unit going."
Carol Meyer, the county's emergency services chief, said CHMC could delay a decision on whether to open a trauma unit until King/Drew's trauma unit is officially closed, the Times reports.
Burke said that she currently does not have the board's support to postpone a decision on the trauma unit to allow a team of medical consultants, who have not yet been hired, to examine the issue. However, she said, "All I'm asking for is a second opinion."
Meanwhile, Garthwaite said, "If we do not take drastic action, King/Drew will be closed," adding that government officials have told the county that the hospital "cannot go on operating the way it is." Garthwaite said county DHS would consider an alternative plan for the hospital but added, "I don't know what it could be."
Currently, "a dozen very skilled and experienced administrators" are working on plans to reform the facility, but no one else has found a better plan, he said. Garthwaite added that by closing the trauma unit, the county's costs might actually increase because of the cost of rerouting patients. However, closing the trauma unit would allow King/Drew to "free overworked nurses, doctors and pharmacists to take care of other patients," the Times reports. Garthwaite said that health officials are working to ensure ambulance travel times would not be longer if King/Drew closes its trauma unit.
County DHS spokesperson John Wallace said, "The current planning would keep it within the 30 minutes," which he said was within acceptable time limits.
Dr. Daniel Higgins, who heads the county medical association and is an emergency department physician at St. Francis Medical Center, "softened" his opposition to the plan to close King/Drew's trauma unit, saying area hospitals could take on King/Drew's patient load provided they receive adequate assistance from the county, the Times reports. With additional financial support, St. Francis "can take 300 to 500 patients if 1,000 go to California and 500 go to" Harbor-UCLA Medical Center, Higgins said.
In addition, Gail Anderson, medical director at Harbor-UCLA, said the facility could care for more patients if additional resources are provided. Currently, the county trauma system is "staggering under the cost" of uncompensated care for uninsured patients, the Times reports. According to Higgins, "the trauma system will collapse by the end of the year" if permanent funding is not secured (Los Angeles Times, 9/21).
KPCC's "Talk of the City" on Monday included an interview with Garthwaite about how the department plans to redistribute the trauma case load among other hospitals (Felde, "Talk of the City," KPCC, 9/20). The complete segment is available online in RealPlayer.
In addition, KQED's "The California Report" on Tuesday will include a report on the upcoming decision on closing King/Drew's trauma unit (Cohen, "The California Report," KQED, 9/21). The complete segment will be available online in RealPlayer after the broadcast.