The "culture of excuses and blaming" at Martin Luther King Jr./Drew Medical Center is so deeply ingrained that fixing the troubled public hospital probably will take much longer than a year and cost much more than the millions of dollars Los Angeles County has committed to the effort so far, officials said Monday.
Just getting King/Drew "back to an average American hospital" will take at least a couple of years, said Dr. Thomas Garthwaite, director of the county Department of Health Services.
His assessment came as the consultants hired to turn around the hospital issued their first evaluation of King/Drew -- a lengthy report that lists nearly 1,000 recommendations for change.
Some of the proposals by Navigant Consulting, which has a one-year, $13.2-million contract at King/Drew, addressed basic medical failings by the hospital's staff. Those failings persist despite months of scrutiny by regulators, the health department and the media.
In detailing how those problems have continued, the report implicitly criticizes the county health department, which directly managed King/Drew from December 2003 until Navigant arrived in November.
The consultants explicitly suggested that the problems would not get better so long as the Board of Supervisors continues to be in charge.
"At minimum and immediately, a separate, independent and knowledgeable board" should be appointed to oversee the hospital, the consultants suggested.
Over the longer term, they said, a separate hospital authority should be created -- a system in use in some other metropolitan areas to try to shield hospitals from political interference. Los Angeles County supervisors have shown little interest in such an independent board in the past.
Regardless of who has ultimate authority, the consultants' report indicated how difficult the process of fixing the hospital will be. In the psychiatry department, for example, "all staff need to be reevaluated for competency," the report states.
The report stressed the problems caused by what the consultants referred to as King/Drew's "culture," in which management has not insisted on accountability and staff members have not always taken responsibility for doing their jobs properly.
After briefings by Navigant officials Monday, several supervisors said that changing the hospital's culture probably will mean firing staff, even if they are veteran doctors with strong community ties.
