The Consultant's Desk

The Consultant's Desk
Poring over the details on your behalf

Wednesday, June 27, 2007

Consultant's Recommendations for the Health of All

There are many instances when an Organizational Development Consultant's input is vital to the health of an organization, its constituents, and its employees. With our airwaves, from coast to coast and border to border, being bombarded with news of the horrors of King-Drew Harbor General Hospital, it became mandatory that the knowledge I have regarding the facility, through experience and observation, be delivered to those responsible for its governance. On the last Tuesday of the month, the Los Angeles County Board of Supervisors Hearing is open to public comment and testimony (during debate on agenda items) for the Board's consideration before taking a vote on the measure before them. It was time for me to address the body and, during public comment, deliver the information I have.

The Supervisors' concerns focused on having a community emergency care facility in the community. More importantly and especially in light of the shocking story of Edith Isabel Rodriguez, who was allowed the die in the triage area, a safe and competent emergency care facility. To close the facility would cause multiple, grievous hardships on the population and drive up numerous infrastructure costs as well as costs to human lives.

The Supervisors asked many questions of their experts and counsels. They examined numerous documents while in chambers and drafted motions to address the issues and needs before them during session. They acted as a team, as a collective body focused on a single mission. Among the considerations were the alternatives that would be available should the hospital's license be suspended compared with revoked. Also among the considerations were the impact on nearby emergency room facilities, ambulance service, waiting time and so on, should the license be suspended, revoked, or the facility closed. The only view was with regard to multiple failures in the emergency area.

Public comment came after more than two hours of Board deliberations. The sister and brother of Ms. Rodriguez were allowed to address the body. Ms. Rodriguez's siblings emphasized the need for those who need to use the facility in the future know that they will be treated with human consideration and not disregard.

Many others spoke before my name was called. They had very relevant words to add to the picture and things to be considered in regard to emergency care. Some offered their services as resources for evaluating and replacing existing staff. Some had prepared statements as written in briefs that were left for later review but accompanied verbal testimony or comment.

I spoke, not as an emergency care recipient but as a person sent to the facility for routine testing and evaluation and as an independent observer of the conditions at the facility. Those observations showed that the problems with the facility are not isolated to the emergency care. Instead, the issues are systemic.

The Board spoke of having gone through the facility some years ago and discovered they had people who simply did not know their jobs, They were the "F performers," as Yaroslovsky put it, but they didn't get rid of the ones doing D- work. Apparently he spoke of emergency room performers. In my interface with the facility, I discovered staff people who could not tell a constituent where a department or room was located or in which wing of the building they should go to reach it. A technician who saw a patient on one day and injected them with imaging dye did not, on the next day, remember that they had injected that same patient. They then wondered aloud at the puncture wound. Yet the workload was not so high to have caused that level of forgetfulness. And one department had three out of four attendants who appeared to be on heavy anti-depressant medication yet all seemed to be equally responsible for patient management, records, and dispensing of instructions. They did not appear to be in a condition to do these functions unsupervised.

A hospital is a building, nothing more. The things that differentiate it from any other building are the equipment, the personnel, and the type of business it does, and how it does that business. Every part of the facility that I saw was immaculate as far as cleanliness. All of the equipment and machinery that I experienced was in good working order. This relates to the general facility. I did not experience the emergency room nor that area.

While the emergency room at Harbor General is in dire condition, the issues that impact the hospital are more profound. It is the hospital staff in general, the people who work there, who need the evaluation. This is the job of the Human Resources department -- the place where the recruiting, testing, screening, hiring, training, retention, and promotion activities take place. The Human Resources department is also the place where determinations about who needs to be given leave of absence until fit to return to work and perform in a reliable manner, how long that leave should be, that does this type of review. Yet it appears the Human Resources department is not capable of fulfilling those responsibilities.

It also appears the recruiters who are part of the Human Resources department are not capable of finding the qualified talent that can deliver on the promises to the community -- safe and competent care provided by qualified talent at all levels. This is something very important to Supervisor Molina. She wants to know that if she takes her mother to that facility, that her mother will receive competent care and that her mother will be safe.

The Rodriguez siblings made an excellent point during their opportunities to speak. People who use the facility are treated as though they are fungible entities, not human individuals entitled to human rights and dignity. For the most part, it appears the treatment is because people who seek treatment at that hospital are viewed as the poor and indigent because their either have no health insurance or are extremely under-insured. Compounding these indignities, it is apparent in many instances that the constituents are also viewed as being the stereotypical representative of their perceived race and therefore treated as the lowest common denominator of life.

Although one-on-one conversations with facility personnel had polite and humane sounds, there were many subtle suggestions in the way things were said or the terminology used, that the individual held the belief that the constituent was merely another of those in the baseline population. The condescensions were ignored in deference to learning more about the primary issue.

So in my capacity as an Organizational Development Consultant, it was possible to deliver information and testimony to the Board of Supervisors that was sorely needed in order to make a more informed decision about whether to close King-Drew Harbor General Hospital or keep it open. It was possible to bolster their findings in order to also help them determine which alternative is the more advantageous, license revocation or voluntary suspension. And with that bolstered information, they will be able to make deliberate in anticipation of a vote that is in the best interests of handling the issues of the hospital, the community it serves, as well as the impact on surrounding communities and populations.

It was good to once again work with a long-time professional friend. It's always good to be immediately recognized and acknowledged even after nearly a decade of absence in association. Finally, it was good to return to my indigenous state in doing public speaking and address in order to inform, educate, and persuade.

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