King/Drew Statistics to Remain Under Wraps
Reversing a policy of openness, Los Angeles County health officials are refusing to release statistics on the quality of care provided by troubled Martin Luther King Jr./Drew Medical Center.
Former leaders of the Department of Health Services released data last year on the number of deaths, medication errors, patient falls, infections and medical mishaps at King/Drew, saying they wanted to be transparent about the hospital’s recovery. Some of the statistics are even posted on the county’s website.
But the department’s new executives denied a Public Records Act request by The Times for updated information, saying state law protects the privacy of hospital efforts to examine and improve their care. The newspaper did not ask for details of specific cases or patients.
King/Drew, just south of Watts, lost its national accreditation last year and has been threatened with a loss of federal funds following a series of lapses in care that repeatedly led to patient deaths.
The county’s lawyers say the health department is within its legal rights to change its mind.
“The prior administration had a policy toward openness with data that other people don’t share,” said Anita Lee, principal deputy county counsel.
“The new administration could legitimately decide that the old administration gave out information that for sound public policy reasons could be kept private,” Lee added. “It is a decision over which conscious, well-thinking minds can disagree.”
But Jim Lott, executive vice president of the Hospital Assn. of Southern California, said changing its policy only makes the hospital look bad and raises suspicion. Although he didn’t agree with the decision at the time, Lott said former county health director Dr. Thomas Garthwaite set a deliberate precedent by making the King/Drew data public.
“Perhaps Garthwaite should not have ever adopted such an open policy, but he did, and retrenching on that policy may send the wrong message to a lot of people,” Lott said.
“To take it away can suggest that you do have something to hide,” he said. “It’s like trying to unscramble an egg.”
Dr. Bruce Chernof, who replaced Garthwaite as health director, said state law has a specific provision that protects hospital quality assurance efforts from public view, and the requested data falls within that realm.
“I wouldn’t release these data for any of our other hospitals,” Chernof said. “Private hospitals in California wouldn’t be releasing any of these data. [King/Drew] needs to perform at the same level as every other hospital.”
Chernof and officials at the California Hospital Assn. said they worry that hospital employees could hold back key information on problems or errors if they knew it might be released publicly.
“You want to make sure you get all the information, bring it all out on the table without the fear that it will be publicly reported and conclusions drawn that might be inappropriate,” said Dorel Harms, vice president of professional services at the association.
The debate about King/Drew’s statistics comes as hospitals nationwide are releasing data that they once considered confidential. A federal website unveiled last year, for instance, allows consumers to examine nearly all hospitals, including King/Drew, on how well they treat patients with heart failure, heart attacks and pneumonia.
Those data suggest that King/Drew generally fared worse than the national average and the county’s other public hospitals between July 2004 and June 2005.
County Supervisor Gloria Molina said through a spokeswoman that she supports Chernof’s position. County Supervisors Don Knabe and Yvonne Brathwaite Burke said last week that they did not have enough information to comment.
But Supervisor Mike Antonovich said he has doubts about the health department’s decision and will ask Chernof about it at Wednesday’s board meeting.
“It’s the public’s right to know,” Antonovich said of the quality-of-care information. “It should be available for all hospitals.”
Supervisor Zev Yaroslavsky declined to comment through a spokesman.
Garthwaite, the former health director, said in a recent interview that he has long favored transparency.
Given King/Drew’s history of problems, he said, the need was even greater.
“I just felt there was so much in the papers that we had to assure people that we were making progress,” he said.
Tom Newton, general counsel of the California Newspaper Publishers Assn., said the county’s refusal to provide the data doesn’t make sense.
The legal provision cited by health officials “was intended to protect individuals in the healthcare field from fishing trips by lawyers by shielding their identity and information about specific incidences,” Newton said.
The information requested by The Times “is the most basic information about how a public hospital is performing, like the total number of deaths that occurred in a particular month,” Newton said. “How that particular piece of information can be protected by putting that information into a quality-assurance proceeding is beyond me.”
The quality data provided to The Times last August by previous health department leaders show that King/Drew was struggling to reduce medication errors. Such errors increased from 74 in January of last year to 200 in June, an increase that Garthwaite attributed to better reporting and recordkeeping.
On the other hand, the hospital had reduced the number of patient falls each month from a high of 10 in January 2005 to two each in May and June of that year.
Last week, Chernof’s department did provide the newspaper with some requested administrative and financial data on King/Drew. The statistics show that about two-thirds of the registered nursing care at the hospital is provided by temporary staff, up from 40% in January 2005. Experts say the higher the number of temporary personnel, the greater the chance of errors.
The data also show that operating rooms at the hospital are being used more efficiently and urgent medication orders are being processed more quickly.
The number of emergency room visits in the first three months of this year was up significantly from the same period a year ago.
Chernof said the now-confidential quality data show that King/Drew continues to make progress. “Honestly, if you look at the measures that you’re pushing for ... they’re really improving. The facility is really improving.”