Sharp admits communication errors

Union Tribune (2008-08-05) Angelica Martinez and Cheryl Clark

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More Info: Local Politics, Grossmont Healthcare Board

District board heard of issues in media

By Angelica Martinez and Cheryl Clark

UNION-TRIBUNE STAFF WRITERS

August 5, 2008 LA MESA – The Grossmont Healthcare District board should not have been kept in the dark about failings that led to the deaths of three patients in recent months and now threaten all federal funding for Sharp Grossmont Hospital, Sharp officials acknowledged yesterday.

NANCEE E. LEWIS / Union-Tribune Vera Giles, who said she worked at Sharp Grossmont Hospital for many years, left the podium after speaking at a Grossmont Healthcare District board meeting yesterday. “You did not do your job,” Giles told board members regarding their communication lapses.

“One of our errors was our focus on communication with the corporate board and not the district board. We would like to apologize. It will not happen again,” said Dan Gross, executive vice president of the Sharp Health Care network. He spoke during a special meeting of the board in La Mesa.

In recent months, he said, Sharp's corporate board has been updated on serious management, training, safety and quality-of-care problems cited during state investigators' inspections of Sharp Grossmont in April and May.

But board members of the taxpayer-funded district didn't hear about the crisis until reading or hearing about it in the media last week.

Instead of attending the corporate meetings, they designated substitutes to do so. Board vice president Deborah Mc Elravy said yesterday that she will stop that practice immediately.

But it remains unclear what, if anything, the district's board members or their substitutes could have done if they had learned about Sharp Grossmont's troubles early on.

Those people have signed confidentiality agreements with Sharp that effectively bar them from revealing contents of the corporate meetings.

Yesterday, Sharp leaders and the district board said the confidentiality requirement is one issue they're trying to resolve as they create a formal process for sharing information.

They expect to vote on the revised communications protocol Aug. 15.

Perhaps a bigger challenge for the district board is determining what role it should play in overseeing Sharp Grossmont.

In 1991, the cash-strapped district leased the hospital to Sharp Health Care for $1 a year. The lease will expire in 2021, with options to renew it for 30 more years.

Over time, the district's board has kept a largely hands-off approach toward day-to-day operations at Sharp Grossmont, which serves a 750-square-mile area in East County with about 652,000 residents.

It usually focuses on the facility's equipment and building needs, such as spearheading a $247 million construction bond measure that voters approved in 2006.

Some of the roughly 70 people who showed up at yesterday's meeting said the district board also is at fault.

“You did not do your job,” said Vera Giles of La Mesa, who added that she worked at the hospital for many years. “How could you possibly not know this was happening? How could you have allowed such superficial contact?”

John Whalen, who lives in Alpine, said: “I elected you people to represent me and you chose not to go to the hospital's board meetings. . . . If either the five of you cannot go to the board meetings, you should resign because you are being negligent in the performance of your duties.”

The board will review its lease with Sharp if problems continue at the hospital or its members believe other terms of the contract are not being carried out, said Barry Jantz, CEO of the district.

“It's not like the first 16 years of this relationship have been a failure,” he said. “We have a very serious situation right now, but we hope to continue in the future. We're not preparing for the worst.”

During the inspections of Sharp Grossmont, the investigators noted problems such as preventable deaths; improper use of restraints in the psychiatric unit; lack of knowledge about cardiopulmonary resuscitation among some nurses; expired medications; an old operating bed held together by tape and glue; substandard cleaning of kitchen equipment; and poor food storage and preparation.

The hospital will lose all Medicare and Medicaid (called Medi-Cal in California) money by Oct. 15 if health regulators don't approve its turnaround plan. Hospitals rarely face this threat, but the ones that do typically manage to keep their government funding.

Several doctors and former patients at Sharp Grossmont praised the hospital's staff during yesterday's board meeting.

Ronald Vaughn said he was pleased with the treatment he received there after being diagnosed with West Nile virus recently. “I just want to thank you very much for saving my life,” he said.

Patient care is taken “very seriously,” said Dr. Marc Kobernick, the hospital's chief of staff. He expressed belief that a great hospital is measured by its long-term quality and its ability to learn from mistakes.

“We all feel immense and sincere sorrow for the (deceased) patients' families,” Kobernick said.

But several patients and patients' relatives recounted horror stories.

Lynn Ucker of La Mesa said her 26-year-old daughter-in-law died at the hospital in March 2007. The death was not mentioned by health regulators in their recent reports.

“She should be alive today,” Ucker said. “Add her to the growing list of patients who received deplorable care and had a deadly outcome.”