Group to Urge Single Executive at King/Drew

A single chief executive officer should be appointed to manage both the troubled Martin Luther King Jr./Drew Medical Center and its affiliated medical school, instead of the current separate leadership, a task force will recommend today.

A unified management, according to the proposal, would eliminate the finger-pointing and poor coordination between Los Angeles County, which runs King/Drew, and the Charles R. Drew University of Medicine and Science, a private institution that contracts to oversee doctor-training programs there.

“A single executive can bring together the two institutions and break down this barrier that has built up over time,” said Dr. Cornelius Hopper, chairman of the Steering Committee on the Future of King/Drew, which is issuing the report. The panel was created by the nonprofit health-oriented California Endowment to propose ways to improve the medical complex, which has repeatedly been faulted by regulators for poor patient care and mismanagement.

The panel’s non-binding recommendations drew a mixed reaction, and county officials said it’s too early to say if they will be enacted.

Some university hospitals and medical schools such as UCLA’s have clear lines of authority that help reduce conflict, said Dr. Michael Drake, vice president of health affairs for the University of California system and a member of the steering committee.

But at King/Drew, doctors and medical leaders are accountable to both the county and Drew University. “With the two masters, it’s unclear what’s the message the person is getting on any particular day,” Drake said. “That’s led to inefficiency and confusion. Ultimately somebody has to be responsible.”

Similar divisions of leadership exist at Harbor-UCLA Medical Center, a county hospital that contracts with UCLA for training and has not experienced the types of problems incurred at King/Drew. County-USC Medical Center cedes more oversight of physicians to USC but does not give the university a formal say in hospital management. The steering committee suggests that King/Drew’s new executive be jointly appointed by county supervisors and the Drew board of trustees, but it does not provide logistical details.

The county’s health director, Dr. Thomas Garthwaite, was a member of the non-governmental task force but said he did not support its central proposal for unified management. He said he would not recommend the idea to the Board of Supervisors until Drew University shows that it has fixed its own problems.

Earlier this week, Garthwaite said his agency was moving to sanction the school for failing to meet some of the requirements in its contract to oversee hospital residents and provide some clinical services at King/Drew. The sanctions are expected to range from $10,000 to $20,000.

The local hospital association similarly found fault with the suggestion. “It’s like saying the best way to repair a relationship is to force the people to get married -- and that’s not the way to fix any relationship,” said Jim Lott, executive vice president of the Hospital Assn. of Southern California. “They need a time out and both sides need to get their own egos in check and then see what they can do together.”

He said sanctions, such as those in the current contract, may be a “more effective” way to ensure accountability.

County Supervisor Yvonne Brathwaite Burke, whose district includes King/Drew, said she is intrigued by the steering committee’s proposal because she imagines a day when the hospital emerges from its current difficulties.

“At some point, you need to get somebody who can bring all of these entities together,” she said.

Also on Tuesday, members of the Board of Supervisors criticized an outside consulting firm’s request for more money to improve patient care at King/Drew. Navigant Consulting Inc. has asked the county for a $3.4-million increase beyond the $13.2 million it is receiving to do the job this year. The new request includes five nurse managers at $36,000 each per month.

“I was under the impression they were going to come in like a fire department to put out a fire, instead of a lawyer that’s going to assess the situation and, you know, bill a client,” Supervisor Mike Antonovich said. “We’re getting the bills but we’re not getting the necessary changes.”

Supervisor Gloria Molina agreed, saying she opposes the increase. “They were supposed to turn around this hospital. They were supposed to do it within a one-year period. They were supposed to do it ... at the price that they came in and said they were going to do so.”

County health director Garthwaite, who previously wrote a memo supporting the higher fee, told the board Tuesday he was still negotiating with Navigant.

The board is expected to formally consider it next week.

Also on Tuesday, county supervisors appointed the final four members of a 15-person advisory group to guide the county’s decisions on King/Drew. That group is separate from the steering committee that issued Tuesday’s report.

The new appointees are: former California health director Diana Bonta; Roger Seaver, president and chief executive of Henry Mayo Newhall Memorial Hospital; James Yoshioka, president and chief executive of Citrus Valley Health Partners; and Sylvia Drew Ivey, daughter of Drew namesake and blood banking pioneer Charles R. Drew.