tag:blogger.com,1999:blog-32053362.post5431699944640531553..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: It's time to sue the trusteesPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger12125tag:blogger.com,1999:blog-32053362.post-50796020156973118582015-07-15T12:39:43.840-04:002015-07-15T12:39:43.840-04:00Wow, post above " the word secret" is w...Wow, post above " the word secret" is what I was going to use instead of "denial". Thought denial covered everything more! Carolehttps://www.blogger.com/profile/02916598876575236275noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-73796999493782969172015-07-14T19:15:17.072-04:002015-07-14T19:15:17.072-04:00"Team based care"? "Team based deni..."Team based care"? "Team based denial" ? I always assumed that already existed... Brad had some pretty legit points for sure. Those who are responsible for the denial,, are not part of the solution, not even part of the problem, they are indeed the PROBLEM. Right or wrong, good or bad it's a job and someone has to do it. With that way of thinking, that's how their able to sleep at night. Profits will always come before patients , let's just be honest. There are many good people with good intentions, I just wonder if there's enough of them to get the much needed changes done. In the long run it benefits us all, hospital staff and patients like Mr. Levy stated. Carolehttps://www.blogger.com/profile/02916598876575236275noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-30859568140348505122015-07-14T09:31:47.615-04:002015-07-14T09:31:47.615-04:00Yes! I have a good story of how conflicts between ...Yes! I have a good story of how conflicts between people employed by the hospital corporation that had a surgeon where there are many "discrepancies" at, that I said/told them in writing did nothing to fix the problem. That led to the surgeon talking about me and id'ing me to someone off the street. That behavior should have been nipped in the bud a long time ago. Twice the surgeon stated he wasn't supposed to say anything but did. <br /><br />Its time business people are held responsible when profits come before patients. <br /><br />I don't have he said/she said, I've got things in writing. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-39990754844172152592015-07-13T18:23:26.531-04:002015-07-13T18:23:26.531-04:00Ms. Clarkson, ...Ms. Clarkson, <br /> God bless you and your mother for your loss, and the amazing amount of strength it will take to get justice for your father. Because I lost my beloved mother to negligence as well, after I read your story, and before I could start writing this, I broke down and cried like the day I lost her knowing I will never get justice for her and it hurts so deeply. The blessed lesson I learned from this tragedy is how majorly important five little letters put together can make on someone else's life. S. O. R. R. Y. "Sorry" :( . That's all I really wanted, since I knew I couldn't get my mother back, of course that would of been my first choice. Good luck to you on your journey for truth and accountability. God bless your Dad and my Mom and may God continue to comfort them. And I pray my mom knows I tried and I'm so sorry for not having the strength to endure the process. Carolehttps://www.blogger.com/profile/02916598876575236275noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-29956285047748345732015-07-13T15:33:24.662-04:002015-07-13T15:33:24.662-04:00This post prompted me to reflect on the Board of T...<br />This post prompted me to reflect on the Board of Trustees at the hospital in my mother’s small Kansas town. My concern is whether the members without clinical training are even in a position to inquire about (and act upon) patient safety concerns, if those with clinical training would prefer to discourage any oversight of safety issues.<br /><br />My father died after a serious error in a small Kansas hospital. My mother and I met with the CEO a few months later. He dismissed our concerns. When we followed up with a letter, he informed us that he is not allowed to talk to us about my father’s care because that is prohibited by the State of Kansas. (No, Kansas law does say this, but that didn’t stop the hospital (and their legal consultant) from saying this.)<br /><br />My mother and I took two paths in response to this:<br /><br />The first path involves legislation. This started out as an idea formed in a meeting with my mother, the CEO, and the hospital’s legal council to fix the law that prohibited the hospital from talking to my mother. After a couple months went by with no action, I got involved and worked with my mother to draft legislation that would require patients/families to be informed of harm that occurred during their care. (There were a couple meeting with the CEO in the months after that, but I came to suspect that this interaction was largely to run out the statute of limitation so that my family could not file a lawsuit.) I wish that legislation like that was not necessary. I wish that hospitals would regulate themselves — but our experience on the second path shows the need for it.<br /><br />The second path was to try to work with the hospital (and Board) to get them to recognize the right of patients to know what has happened in their care. For example, we wanted a statement in the patient bill of rights. We had a reasonable chance of working with the Board of Trustees on this, because two of the members of the Board knew my father quite well (one through work, one through church). And yet, nothing from the Board, other than a condolence letter. Nothing. Silence. <br /><br />We had stated in a letter early on that we were considering a lawsuit, but we would prefer to work with the hospital to improve communication and safety. They chose to not work with us, and by doing that they chose a lawsuit. I can't imagine what they were thinking. <br /><br />Our lawsuit will be entering mediation this October. So much information that would otherwise not have been revealed has come to light. And therefore, I think the hospital made the right decision: they needed a lawsuit to wake them up. And this is the best thing that could have come out of my father’s suffering and death — an analysis of the breakdowns and bad decisions that affected my father, because those same factors can affect every other patient in that hospital. <br /><br />So in reflecting on the role of the Board, I wonder… Do board members without clinical training have any knowledge of patient safety? Because if those with clinical training prefer to brush over patient safety issues — because it is much easier to focus on financial topics and developing the hospital’s prestige and stories of saving lives and bringing babies into the world — who is going to insist on talking about the ugly parts? <br /><br />Perhaps Boards only see their role as damage control when lawsuits become public. What if they saw their role in “damage control” as actions that keep patients from being harmed in the first place.<br /><br />So what would it take for members of the Board to see themselves as responsible for ensuring patient safety? As you suggest, perhaps naming the Board in lawsuits. And that is really sad. <br />Melissa Clarksonhttp://disclosemedicalerrors.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-51026308634073662982015-07-13T13:01:28.677-04:002015-07-13T13:01:28.677-04:00I very much disagree, Barry. There are many examp...I very much disagree, Barry. There are many examples of hospitals with non-employee MDs who have been able to work cooperatively with them and dramatically enhance quality and safety. Yes, there are sometimes a few recalcitrant ones, but they are few and far between. <br /><br />As for empowering people to speak up, yes, that's essential. Again, there examples of where that has been done.<br /><br />If you approach this in a sensible and respectful fashion, life is better for the staff--and ceratinly for the patients!Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-2044843033587573852015-07-13T12:46:34.161-04:002015-07-13T12:46:34.161-04:00Even if a hospital’s board of trustees wants its h...Even if a hospital’s board of trustees wants its hospital to become an island of excellence, I’m not sure how you create a culture of collaboration and collegiality among doctors if it doesn’t already exist especially if most of the doctors are not hospital employees but independent contractors with practice and admitting privileges. Moreover, if nurses, techs and others don’t feel empowered to speak up if they see something wrong or in need of improvement, how do you change that?<br /><br />It seems that for the hospital to get from point A to point B, it may have to fire or withdraw privileges from doctors who won’t embrace the new culture which, in turn, could create significant disruption and financial hardship for the hospital in the short term. In order to become an island of excellence in the long term, you first have to survive financially in the short term. That may be easier said than done.<br />Barry Carolnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-40231540116779640152015-07-13T01:27:58.974-04:002015-07-13T01:27:58.974-04:00From Facebook:
Love this. Goes straight to the he...From Facebook:<br /><br />Love this. Goes straight to the heart of accountability. Most boards get D&O insurance so individual members aren't personally liable (all nonprofit board members should insist on this, by the way) but your idea speaks to collective culpability. Bravo.Naomi Kaufman Pricenoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-29786982136104427662015-07-13T01:22:50.801-04:002015-07-13T01:22:50.801-04:00Very well stated.
It is time to call the question...Very well stated.<br /><br />It is time to call the question. Any other industry would be regulated already based on the slowness of change demonstrated by many.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-19280105641019665092015-07-12T21:09:47.787-04:002015-07-12T21:09:47.787-04:00Yikes! What you're proposing might actually wo...Yikes! What you're proposing might actually work, which of course means it will never see the light of day. Far too many trustees are far too politically connected, I'm afraid. (Yes, I get that this is the judiciary you're talking about but these days judges seem to think they report to the party that had them appointed.)Al Lewishttp://www.quizzify.comnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-42517432680404043242015-07-12T20:48:58.376-04:002015-07-12T20:48:58.376-04:00Wow! Strong words indeed, but they needed to be sa...Wow! Strong words indeed, but they needed to be said. I would like to comment on the following nuggets:<br /><br />1. "Regular readers know that I have seldom pulled my punches: There are enough people who try to be diplomatic in what they say and how they say it."<br /><br />Right on. People are sheep. Stop it. It is critical right now in health care that we speak up, as the hour of change is finally at hand. As the highway signs in my home state say, "See something, say something."<br /><br />2. "He posited that the medical profession has failed in this regard—avoiding discipline of their members who are clearly impaired, incompetent, and negligent." <br /><br /> I would definitely go further than that statement. Our profession through its specialty societies has profoundly failed to discipline its members for even more egregious offenses such as willful lapses of ethics, deliberate conflicts of interest, or even outright criminal conduct such as the oncologist in MI.<br /><br />Our profession's training organizations have profoundly failed our patients and professional members by refusing to move more quickly to change curricula to train medical students and residents in the very organizational imperatives for safety and quality which you point out that they lack. People have been noting this deficiency for years. Not only does this kill people, but it leaves doctors as the powerless 'labor' force to be directed, however reluctantly, by the 'management' of CEO's and trustees to which you refer, as medicine corporatizes.<br /><br />3. "But it’s time for a broader definition of negligence: Negligence today is found in a hospital that has not used the wealth of data and experience garnered around the world by the “islands of excellence,” those thoughtful hospitals who have created a new standard of care by the manner in which they have organized work and by the existence of a culture of continuous process improvement." <br /><br />You are absolutely right. There is no excuse for not learning the lessons that are out there for the taking by anyone who wants to improve. This should be the new legal definition of an institutional standard of care.<br /><br />I hate that the only thing which forces needed change in American business is often our world-renowned litigation system, but in so many other arenas that is all that has worked. So be it. Bring it on. nonlocal MDnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-20692080109734998482015-07-12T20:29:51.951-04:002015-07-12T20:29:51.951-04:00Paul
Although we reference "team-based care&...Paul <br />Although we reference "team-based care" as the model we have, or we are evolving too in hospital care, I always find irony in our litigation system. If we have and want team based care, why not include nurses, pharmacists, and social workers in actions. They are the team. Docs no longer belong at the center of the wagon wheel (with exceptions of course). That's if we are evolving to that higher plain of course.<br /><br />With your proposal, if we assume trustees oversee the team and entire enterprise, by fiat, boards should always be fully accountable. <br /><br />So if we assume a new normal: Trustees first, then "team," in no particular order, second.<br /><br />BradBrad Fhttps://www.blogger.com/profile/10366408815395434941noreply@blogger.com