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CMS - Medicare OPTN

Parkland Memorial’s Compromises Patient Safety

The Dallas Morning News released a copy of a CMS report on Parkland Memorial Hospital in Dallas after hospital officials refused to release it to the public, fearing lawsuits. CMS’ investigation, meanwhile, was conducted after Parkland “failed a series of inspections prompted by the death of an illegally restrained psychiatric patient”.

The CMS investigation cost about $7 million in tax payer money.

Patient rooms were found to contain overflowing trash bins, excrement and blood. Hundreds of medications were improperly administered to patients. Dozens of beds remained empty despite crushes of patients seeking emergency care. Senior leaders kept critical information from the hospital’s board of managers. One patient died, apparently after receiving a drug without doctors’ orders.

The report also identified a number of cases of patient harm since just last November, a “surprising” finding, the monitors said. Parkland was already under such intense outside scrutiny, and the continued problems suggested corrective actions the hospital pledged “have not been effective in creating a safer care environment.”

The report cited “violations of more than 50 CMS standards — roughly half of all CMS rules governing federally funded hospitals.”

In examining Parkland’s daily operations, the monitors also found fault with faculty doctors from UT Southwestern Medical Center, the hospital’s academic medical partner. UTSW’s faculty comprises most of Parkland’s physician workforce and supervises the resident doctors-in-training who deliver much of the care at the teaching facility.

The safety monitors said problems in the residency program, jointly managed by the two institutions, are a factor in Parkland’s care issues. Unsupervised residents botched several invasive procedures, for example, including draining chest fluid from the wrong site.

 

Other than the obvious, why does this warrant a mention? Because Parkland has a kidney and pancreas transplant program.

I looked up Parkland’s data on OPTN’s website. Below is a screenshot (click for full size):

 

Parkland Memorial Hospital transplant program data

 

In 2011, Parkland performed three (3) living kidney donor transplants.

One (1) each  in 2009 and 2010.

Nine (9) in 2008.

One (1) in 2007.

Five (5) in 2006.

One (1) in 2005.

According to Transplant Living* (a site run by UNOS, the contractor for OPTN):

If the center wishes to perform laparoscopic donor nephrectomies, a qualifying renal donor surgeon must be on site and must have:

  • (i) Acted as primary surgeon or first assistant in performing no fewer than 15 laparoscopic nephrectomies within the prior 5-year period.

 

Do we think Parkland only has ONE surgeon that performed all of these living donor nephrectomies? Cuz that’s problematic otherwise (It’s problematic either way, imo).

 

As of this writing, there is no statement on OPTN’s website about Parkland or the CMS investigation.

 

Please, do yourself a favor and read the entire article: http://www.dallasnews.com/investigations/patient-safety/20120214-parkland-safety-report-says-problems-persist.ece

http://www.healthjournalism.org/blog/2012/02/cms-ordered-report-withheld-by-hospital-reveals-hundreds-of-deficiencies/

 

 

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