In a long-overdue move, the California Department of Public Health has decided that Southwest Healthcare Systems be allowed to open most of its $53 million dollar expansion at the Rancho Springs Medical Center that has been sitting vacant for 2 years. At the same time they will be allowed to open the $24 million expansion at Inland Valley Medical Center sitting vacant since last year.
The openings will expand the number of emergency beds at the 2 hospitals from less than 24 to over 45, with another 10 ER beds and 20 postpartum and labor and delivery beds awaiting a follow-up assessment in 30 days.
The Valley has been severely undeserved medically following the rapid run-up in population following the housing boom of the past decade. Despite this, the state saw fit to keep these facilities shuttered. The hospitals were caught in a catch 22 of sorts, required to address numerous safety, overcrowding and logistics problems that would have been resolved by opening the new facilities - but in the state's infinite wisdom, they wanted the issues addressed prior to allowing the facilities to be opened. As a result, ER visits often extend for hours, surgeries were eliminated at Rancho Springs as those spaces were converted to ER use, and the region continued to suffer from a lack of a Womens Center and NeoNatal Intensive Care Unit and Surgi-Center.
So what precipitated the moderation of the state's position? Change. Change at the hospital and change at the state. Mid-year the hospitals parent corporation, Universal Health Services, Inc., brought in CEO Ken Rivers to oversee a systematic restructuring of staff and facilities. Shortly thereafter, Rivers replaced several members of the Board of Governors and brought in several top-level adminstrators to head nursing, ER and other departments. (In the interest of full disclosure, I was one of those named to the new Board).
During the past 6 months the hospitals have undergone numerous changes to the organization that resulted in a wholesale improvement in attitude, new direction, improvement in compliance and other issues of concern to the state and federal authorities. All these changes were accomplished within the constraints of the capacity issues at significant cost to the healthcare system - a cost in both financial terms as well as reputation as local residents bore the brunt of extended wait times and lack of availability of some services. Right or wrong, these issues were blamed on the provider rather than at the feet of the regulating authorities making the decisions.
The question remains, were the problems significant enough to warrant the heavy-handed tactics by regulators or were there other elements at work as well? It should be noted that another significant personnel change also occurred at the state level with the reassignment of the state's Director of Compliance and Certification. A new acting Director in place for 4 months and all the serious problems are resolved? I know there's a whole new attitude at the hospitals but really? Four months from failure to success?
It is also no doubt coincidental that problems for the local hospitals started about the same time as a vote to keep unions out of the facilities about 2 years ago. It may also be coincidental that the hospitals became the most scrutinized and inspected hospitals in the state during the past two years, as well as among the most heavily fined. It's probably also of no significance that most of the problems ascribed to the hospitals to support the state's position were relatively minor - nurses wearing the wrong colored hats, instruments left in sterilizing solution too long, humidity spiking too high in a trauma center,that sort of thing.
Few issues were raised that involved improper patient care, no issue that lead to the incapacity or death of a patient. Unlike other facilities where such occurences are admittedly more commonplace, they are not here - yet the facilities were scrutinized as if patients were dropping like flies in the hallways. More patients were harmed by lack of availabilty of beds and services than were ever harmed, or even alleged to have been harmed, by having the services available even in the crowded conditions that existed.
Oh well, what's done is done - the past is behind us and the future looks bright. Even with the opening of the new facilities and the much awaited grand opening of the new Loma Linda Medical Center-Murrieta, our Valley will remain underserved in beds per thousand. But the expansions will go a long way toward helping address that and the quality, timeliness and scope of healthcare in the Valley will improve significantly.With all the inspections and compliance issues, it's probably a safe bet that the quality of healthcare provided at these two facilities is currently among the best in the state.
Special thanks to Pamela Dickfoss, new acting Deputy Director of the California Department of Public Health, to Ken Rivers, CEO of Southwest Healthcare Systems and especially to the staff and physicians who have worked so hard to make the healthcare experience a little easier for everyone. It seemed like sometimes the deck was stacked against them yet they persevered and sought continually higher standards of care for their patients.
And in the end, that's really what it should be all about. It's tough when folks play politics with peoples lives.
Of course that's just my opnion - I could be wrong.
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