King/Drew Overhaul Gets Mixed Review

The outside consulting firm being paid nearly $21 million to overhaul Martin Luther King Jr./Drew Medical Center has fulfilled many of its goals, but some key reforms have yet to be completed, according to a new report by Los Angeles County auditors.

Navigant Consulting Inc., hired in late 2004 to reform the troubled public hospital, is now in full compliance with 81% of the 32 requirements spelled out in its contract, a marked improvement from previous audits.

Among its accomplishments, the firm helped recruit new top administrators for the hospital, enhanced nursing policies and oversight, quickly investigated lapses in care and improved operating room efficiency, the report said.

But auditors said Navigant has not provided all the full-time consultants it promised, a fault identified repeatedly in previous reports. A senior laboratory consultant, for instance, had worked only 19% of the required time from June to October 2005 and a senior pharmacy consultant was there only a third of the time.

Also, Navigant has not completed competency assessments of all nurses, has not met its own target for discharging hospital patients earlier in the day and has not ensured that King/Drew’s personnel files have all the required documentation.

In addition, Navigant has not made much progress implementing the specific recommendations it drafted as part of its King/Drew work plan. Auditors reviewed a sample of 21 tasks and found that Navigant had completed only 12 of them, or about 57%.

Navigant was hired after a series of highly publicized medical lapses that led to the deaths of several patients at the Willowbrook hospital, just south of Watts. The hospital’s top administrators had been removed from the job, national accreditors were preparing to yank their seal of approval and federal regulators were threatening to cut off $200 million in funding, which represented more than half of King/Drew’s budget.

Despite the steps taken by the consultants, King/Drew still has not reapplied for national accreditation, a symbolic validation that it meets minimum standards of care, and it remains out of compliance with federal standards, which could prompt regulators to halt funding.

“In a hospital that has faced the challenges that King/Drew has faced, it’s really a herculean task to get to all those issues,” said Dr. Bruce Chernof, acting Los Angeles County health director. “What this audit shows is that they continued to make progress -- more progress in some areas than others.”

A Navigant spokesman acknowledged Monday that a lot of work still needs to be done but said the team is proud of what has been accomplished.

“The overall quality of care has been increased. Patient mortality rates have decreased. The emergency room waiting times have decreased, and there’s been an overall increase in the compliance and preparation” for regulatory visits, said Navigant spokesman Andrew Bosman.

The firm’s longtime critics were not satisfied. In fact, county Supervisor Mike Antonovich said Navigant has been a “dismal failure.”

“With the federal government’s certification inspection looming, Navigant’s failure to fully complete the necessary reforms as promised in their $20-million contract -- even with a six-month extension -- is inexcusable,” Antonovich said in a written statement.

Navigant, whose stewardship of King/Drew ends this month, has been criticized throughout its tenure at the hospital.

In a June report, auditors said Navigant had failed to act on urgent recommendations it had promised to complete by Feb. 28. Almost a third of those reviewed had not been done nearly four months later.

Then, in September, auditors accused the consultants of deleting from their to-do list some goals the firm had not reached. The report also said Navigant had refused to turn over results of a practice inspection showing how unprepared King/Drew was for a visit by accreditors.

A month later, auditors rejected more than $206,000 in invoices submitted by Navigant because they were for unauthorized trips and first-class travel. The auditors’ action came after The Times reported that Navigant routinely inflated its expense reports by double-billing airfares and charging the county for first-class travel and trips unrelated to the hospital.