King/Drew Remains in Bad Shape

A consulting firm hired to turn around Martin Luther King Jr./Drew Medical Center offered Tuesday its most pessimistic assessment yet of progress at the hospital, blaming Los Angeles County supervisors, media reports and county bureaucrats for slowing reform efforts.

The hospital -- already critically short of nurses -- is losing more nurses than it can recruit, has a backlog of 1,200 X-rays waiting to be interpreted and has failed to resolve a dispute over competency testing for pharmacy technicians, said Kae Robertson, a director of consultant Navigant Inc.

Robertson advised county supervisors to seriously weigh options for the hospital in August, when the board is to discuss outsourcing the facility to a private company, paring back services and severing ties with the hospital’s affiliated medical school.

“I think those options are going to be important for you to evaluate given the magnitude and pace of change,” Robertson said. “It took 30 years to get here and it’s going to take longer than six to eight months to get out of it.”

The tone of Robertson’s comments, delivered at the Board of Supervisors’ weekly meeting, differed sharply from her previous reports, which generally focused on successes at King/Drew. Indeed, Navigant persuaded supervisors in May to give the firm an additional $1.8 million, bringing its one-year contract to $15 million.

At least one county supervisor said Robertson’s comments suggested the consulting firm had decided to leave King/Drew once its contract expires in November.

“I think they clearly indicated they weren’t intent on continuing,” said Supervisor Don Knabe. “I don’t think that they had any idea of what they were up against.”

Supervisor Mike Antonovich ridiculed the consulting firm, comparing its officials to cartoon figures carrying attache cases with nothing more inside than a comic book and a sandwich.

“They were hired to put out the fire,” he said. “That’s their job. They come in and indicate that there’s a fire and they don’t know what to do.”

King/Drew serves as a crucial safety net for the largely poor black and Latino residents in the Watts and Willowbrook neighborhoods. But its existence is threatened as regulators and accreditors have repeatedly faulted the facility over the last two years for poor care and lax oversight of doctor trainees.

County supervisors hired Navigant at the insistence of federal health inspectors. The firm took over the day-to-day management of the hospital in November. The consultants promised to earn back King/Drew’s seal of approval from the Joint Commission on Accreditation of Healthcare Organizations.

On Tuesday, Robertson suggested that goal looked distant and blamed supervisors for previously delaying a $64-million proposal to refurbish its deteriorating facilities.

She also blamed supervisors for failing to follow through on Navigant’s recommendation to create a hospital authority to run the county’s medical facilities. And she complained that Navigant officials are required to spend too much time answering media inquiries and reporting to county supervisors.

Robertson accused county human resources officials of failing to notify Navigant last week before a suspended nurse was marched from the hospital.

“You would question how we can run a hospital like this,” she said. “Unfortunately, it felt like the timing and management of this incident was driven by your meeting happening that day and the L.A. Times saying they were releasing a story.”

Sitting close by, the county’s director of human resources, Mike Henry, objected. “That is totally incorrect,” he said.

“I’ve been sensing that there’s this conflict between all these departments,” said Supervisor Yvonne Brathwaite Burke. “Somehow, someone’s going to have to bring all of them together to cooperate.”

Supervisor Gloria Molina agreed.

“I must say, this report doesn’t share with me, Kae, that there is progress,” Molina said. “It tells me that we need to referee here.”

The hospital has continued to struggle in its efforts to recruit nurses and their supervisors. Five of the hospital’s six top nurse managerial positions are vacant, with one open for eight months.

Recruitment has been hurt by reports of continuing mismanagement and patient-care lapses at the hospital, said Dr. Thomas Garthwaite, the county’s director of health services. But a shortage of nurses has hampered attempts to fix those lapses, he said. “We’re caught in a Catch-22,” he said.

Garthwaite said he has sought help from the Hospital Assn. of Southern California in the hopes that nearby private hospitals can lend King/Drew nurses for six months at a time. The hospital badly needs an additional 20 to 30 nurses, he said.

“If you look at the health needs of the population served by King/Drew, this is almost missionary work,” he said.