Thursday, January 26, 2006

Gross misbehavior persists at black L.A. public hospital despite crackdowns.

It is what it is and it won't change unless staff selection becomes colour-blind and merit-based. But just getting good staff to go there would be a big challenge. Security would certainly have to be good

More than a fifth of the staff at troubled Martin Luther King Jr./Drew Medical Center has been fired or disciplined during the past two years, records show. Serious behavior problems have continued despite intense scrutiny of the hospital by regulators, auditors, consultants, county supervisors and the media. Lapses have included skipping work, sleeping at work, neglecting patients and fighting with other staff, according to records from the Los Angeles County Civil Service Commission.

Despite the ongoing problems, county officials say they believe the disciplinary actions show the hospital is improving. "I really think we're close to being over the hump," said Michael J. Henry, the county's personnel director. The public hospital south of Watts serves a mostly poor, minority community. Regulators have cited it during the past two years for serious patient-care and management shortcomings including several deaths. King/Drew lost its national accreditation and faces the loss of more than $200 million in federal funding if it fails an upcoming inspection.

Since Jan. 26, 2004, King/Drew has disciplined 524 of its roughly 2,500 employees - 199 of whom have been fired or resigned under investigation, Civil Service Commission records show. Two-thirds of the disciplinary actions took place in 2005. Among the deficiencies that led to discipline:

- An on-duty critical-care nurse fell asleep at a break room table while one of her patients faded and died. The nurse and her boss were fired.

- Several janitors urged a belligerent patient struggling with a police officer to "Kick the police's ass." A janitor who challenged the officer was fired.

- A nurse was fired for being absent a total of almost four months between Sept. 1, 2004 and April 30, 2005.

Most disciplined workers appealed their punishments. Appeals by King/Drew workers accounted for one in seven cases filed with the Civil Service Commission last year, compared to fewer than one in 100 in 2002. "We've had some very difficult and lengthy commission meetings as a result," said Z. Greg Kahwajian, the commission president.



For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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