Navigant Issues Final Recommendations for King/Drew
The Los Angeles County Board of Supervisors should transfer oversight of Martin Luther King Jr./Drew Medical Center from the Los Angeles County Department of Health Services to a "more independent and knowledgeable board" as soon as possible, according to final recommendations issued Monday by Navigant Consulting, the Los Angeles Times reports (Ornstein, Los Angeles Times, 2/1).
Navigant in November 2004 was awarded a one-year contract to propose strategies to address problems at the hospital. The firm issued a preliminary report earlier this month that included about 1,000 recommendations to improve patient care. County officials have 30 days after receipt of the final report to decide how to proceed (California Healthline, 1/4).
Of its 1,052 final recommendations, Navigant said about one-fourth were "urgent," according to the Times. The report's central recommendation suggests that an independent board consisting of finance, business and hospital management experts be given responsibility for King/Drew's medical care and educational programs.
Under such a proposal, the board would report directly to the supervisors and would not be accountable to DHS.
The report also said the hospital's trauma unit most likely will not be able to reopen until at least July 2006.
Navigant also criticized the hospital's scheduling system, which assigns many patients' appointments at only a few times during the day. According to the report, "Patients have to jump through hundreds of hoops to get anything accomplished," and they often wait hours to be seen or reschedule.
Supervisors are expected to discuss the firm's recommendations at a meeting Feb. 8.
Navigant Director Kae Robertson said the hospital's outpatient clinic system is "as broken ... as it was on the inpatient side." Robertson said that implementation of an independent board would create a different form of oversight for the hospital than other public hospitals in the county; however, she said that King/Drew has "special needs" and "more problems than everybody else."
Speaking about Navigant's opinion of the hospital's trauma center, Robertson said, "We very much understand there's a community need for trauma, and it should come back. But the most important thing is that there's a safe environment for trauma patients to be cared for in."
Supervisor Yvonne Brathwaite Burke said she supports the creation of an independent board, citing inaction by the county DHS in the last year. Burke said, "I'm not saying I've lost confidence" in the health department, "but they did have a year to look at all this."
County DHS Director Thomas Garthwaite said the proposal "makes a lot of sense." He added, "We're in the middle of a lot of the decision-making, and having perhaps a group of knowledgeable individuals somewhat removed from that would help provide an additional set of guidance."
But Supervisor Mike Antonovich said an independent board would have "no authority to implement changes." He added, "Having another volunteer advisory board doesn't eliminate the unethical work behaviors that have been reported in the past, nor does it make assurances that King/Drew staff are doing their job" (Los Angeles Times, 2/1).
In related news, Charles R. Drew University of Medicine and Science, the medical school affiliated with King/Drew, this week named four members to its board of trustees and removed one member to reorganize residency training and leadership in King/Drew's 18 physician-training programs.
The board named: Roger Bulger, president of the Association of Academic Health Centers and former president of the University of Texas Health Science Center; Alejandro Mayorkas, a former U.S. attorney under President Clinton; Steven Schroeder, a professor at the University of California-San Francisco and former CEO of the Robert Wood Johnson Foundation; and Richard Veloz, CEO of the South Central Family Health Center.
The board also removed Lillian Mobley, a community advocate who served on the board for 10 years and recently protested what she called attempts to close King/Drew. Mobley was offered a nonvoting emeritus seat on the board but has not yet responded, according to board Chair Bart Williams (Ornstein, Los Angeles Times, 1/28).
The Accreditation Council for Graduate Medical Education in February 2004 recommended closing King/Drew's neonatal residency program. The council previously found King/Drew's oversight of its medical resident training programs to be substandard and decided to revoke accreditation for the facility's surgery and radiology residency programs (California Healthline, 3/10/04).
Williams said the board intends to improve physician-training programs, the school's relationship with affiliated medical centers and raise money to become more independent and stable. He also said the board intends to hire a new president.
The board currently has 13 members and plans to increase to as many as 21 members.
Williams said of the appointments, "The board has been trying to renovate itself for over a year, and all four of these new members help in that regard. We were trying to be more national in scope" (Los Angeles Times, 1/28).