Parkland Hospital officials say they are making big changes after failing two critical safety inspections last year, and a new, independent audit found patients ignored in the emergency room, and dirty operating rooms. KERA’s BJ Austin reports.
The Dallas Morning News obtained a copy of the Alvarez and Marsal report, which Parkland declined to make public for fear of lawsuits.
In the report, safety monitors say they observed serious unresolved issues, including the E-R. The report says a patient moaning in pain was ignored until the independent safety monitors arrived. Infection prevention and control was cited again. The report says safety monitors found duct tape covering a hole in the wall of an operating room and clinicians failing to wash their hands.
Monitors say a “culture” of business as usual has hampered necessary improvements.
Dr. Mel Fugate is an Associate Professor of Management and Organization at SMU. He says fixing Parkland is not going to be easy.
Fugate: To such a large organization, it’s like doing a 90 degree turn with the Titanic. It’s not impossible, but it is difficult.
The report said monitors were surprised to see that doctors and other hospital employees did not share the sense of urgency about Parkland’s situation. Dr. Fugate says that’s a huge hurdle to jump.
Fugate: You know cultures become deeply embedded and it becomes the way that people do things. It will be painful, especially radical change. There will definitely be losers, but there will also be winners in that. It takes tremendous political will. I don’t know if the existing leadership has that political will or the leadership across the larger organization. But, I suspect it will be tested.
Dr. Thomas Royer, interim Parkland CEO called several hundred hospital managers and departments heads to a meeting to talk about media reports and challenges ahead.
Royer: We are going to continue to read stories. We are going to continue to hear stories. I think it is important to remember, you’ve done a lot of hard work. You’ve made lots of progress.
Dr. Royer told the crowd that while about 75% of the complaints in the original inspection have been addressed, there are a lot of very challenging, important issues to deal with. He says they will require a new honesty and self-reporting of problems, plus increased compassion and concern for individual patients.
Royer: We need to make sure that our patients know how good we are. With just the media stories, the Board and I, and our senior team do have concerns. We have concerns that if anyone read the media or hear the TV coverage and whatever, will they really continue to come here with the most important ingredient they have, which is hope?
Dr. Royer says not all Parkland employees will buy into the new policies, procedures and department reorganizations. He says they will be asked to leave. Dr. Royer asked Parkland employees to tell their stories of what’s right, what’s wrong and how it’s being fixed to family, friends and neighbors.
Royer: Ladies and Gentlemen, I came because I saw this as an opportunity of a lifetime for all of you and me together so when we moved into “New Parkland” it would not be a new building, but it would be a new culture.
The Centers for Medicare and Medicaid Services, which ordered the independent audit, says Parkland’s progress will be monitored monthly. Parkland has a year-and-a-half to fix things, or lose Medicare and Medicaid funding – more than 50% of its budget.