The Martin Luther King Jr. Outpatient Center ( MLK OC ), formerly known as Martin Luther King Jr. Multi-Service Ambulatory Care Center (MLK-MACC), Martin Luther King Jr./Drew Medical Center (King/Drew) and then Martin Luther King Jr.- (MLK-Harbor or King-Harbor), is an urgent general care and outpatient clinic and former hospital in Willowbrook, an unrelated section of Los Angeles County, California, north of Compton town and south of Watts neighborhood in Los Angeles. Established as a major public hospital, was closed in August 2007 due to poor patient care records. Urgent care centers and outpatient clinics, however, continue to operate on site. In 2014, a smaller hospital under a partnership between Los Angeles County and the University of California opened as a nonprofit organization governed by seven board members.
The MLK Outpatient Center is operated by the Los Angeles County Health Service Department (DHS). In the 2000s (decades), the widely publicized issue associated with disability and mismanagement caused hospitals to undergo a radical overhaul which reduced the number of beds from 233 to 42 before it was finally closed. Since 2004, 260 hospital staff, including 41 doctors, have been dismissed or resigned as a result of disciplinary proceedings. To reduce the impact on these large capacity loss communities, the Los Angeles County Medical Control Center (Felix: MAC) contracts an ambulance requiring approximately 250 patients per month to another local hospital.
At the beginning of the 21st century and before the crisis, MLK-MACC (then MLK/Drew) has 537 beds, is an educational hospital of the adjacent University of Medicine and Science Charles R. Drew, spread over 38.5-acre (156,000 Ã , M 2 ) sites that included dormitories for the medical population, employed 2,238 full-time personnel, and in 2004 treated 11,000 inpatients and 167,000 outpatients. Located near high crime streets, the hospital has a very active trauma unit. In 2003, he handled 2,150 gunshot wounds and other life-threatening injuries. Because of the large number of gunshot wounds seen by the trauma unit, the US military sent their trauma team to MLK/Drew for training.
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Histori
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The establishment of the facility was driven by the Watts' 1965 Riot. In the aftermath of the riots, Governor Pat Brown appointed the Commission to identify the factors contributing to the riots. This result was the McCone Report of December 1965. One of the major findings of the report was the lack of access to health care near low-income neighborhoods in South Central Los Angeles. At that time, the closest public trauma center was the USC Los Angeles County Health Center, located more than ten miles (16 km) away - an issue exacerbated by the amount of gang violence in the area.
In 1966, DHS formed a task force to develop a full-service community and teaching hospital operated by the County along with USC and UCLA Medical School as well as the newly formed Charles R. Drew Postgraduate Medical School, a private, non-government school. profit medicine schools are set up to train doctors to work in urban poverty areas.
The land was damaged in hospital in April 1968. Originally named Los Angeles County Southeast Hospital General but soon renamed the Martin Luther King Jr. General Hospital, days after the name's murder. After dedication in February, it opened on 27 March 1972 as a full-service medical center. The facility changed its name again to Martin Luther King Jr./Drew Medical Center, when it became an educational hospital at the nearby Charles R. Drew University of Medicine and Science. In 1981 the hospital expanded into psychiatric care by opening the Mental Health Center of Augustus F. Hawkins. In 1998, the center of trauma expanded. In the 1980s, King/Drew was part of the Drew/UCLA Doctor Education Program, training doctors through UCLA medical school partnerships and Drew, and was a source of pride and work in the community.
The fall of the King/Drew
King/Drew enters the 21st century with issues related to incompetence and mismanagement. The lack of quality felt in the hospital has made it a nickname "Killer King." The facility employs travel nurses from across the country in an effort to improve conditions.
Issue revealed
On August 22, 2003, the Los Angeles Times reported that two women connected to heart monitors at King/Drew died after their vital signs were deteriorated undetected. In December 2003, DHS closed the hospital's cardiac monitoring ward after the third patient died under questionable circumstances. A group of consultants is hired to help fix problems with nursing staff; DHS spent nearly $ 1 million on this effort.
In a January 13, 2004, federal Medicare and Medicaid Services (CMS) report determined that the King/Drew did not meet the minimum requirements for receiving federal funds, citing the work of a government inspector who identified three patients who died at King/Drew after what was determined to be a big mistake by a staff member. In March, the CMS declared King/Drew's patients to be in "direct danger" of harm or death by mistake in hospital treatment, citing many mistakes and threatening to withdraw federal government funds from public hospitals. In June, 2004 the CMS again stated that patients were in danger, citing the use of Taser stun guns to subdue psychiatric patients. But again, he threatened to withdraw federal funds but retreated; federal funding reached more than half of King/Drew's operational budget of $ 400 million.
Trauma center closure
On September 13, 2004, DHS recommended the closure of King/Drew's busy trauma unit, saying that hospitals need to put their full energy to fix problems in other areas. Not long after that, the Los Angeles Times revealed that the American College of Surgeons had revoked its agreement on the quality of the King/Drew trauma unit in 1999 and 2003 for failing to properly investigate the death of patients and that doctors routinely missed meetings which was held to discuss treatment issues. Also in September, the Los Angeles County Supervisory Board agreed with CMS to hire a new consulting firm to take over operations at the hospital.
In November 2004, the environmental resistance to the proposed closure (especially the trauma center) was formed, led by US Representative Maxine Waters and joining Reverend Jesse Jackson, Los Angeles Mayor James K. Hahn, actress Angela Bassett and children from Pdt. Dr. Martin Luther King, Jr. In December 2004, the CMS stated that the King/Drew patients were in "direct danger" for the third time. This time cites the heavy staff dependence on Los Angeles Police personnel to deploy Tasers to subjugate aggressive and aggressive psychiatric patients. The federal funds were again threatened, but as in previous times, action was not taken.
Despite protests, negative media and opposition near city political leaders, five members of the Supervisory Board voted four zeroes, with one abstention, to move forward with the closure of the trauma center. A temporary arrest order was filed by a group of doctors and citizens, but was refused. The trauma unit was closed in early 2005. The patient was transferred to three other hospitals, both public and private (with subsidized areas).
A few days later, the Joint Commission on Accreditation of Health Organization (now only the Joint Commission), cites the medical center for failing to correct the severe deviations in patient care, threatened to withdraw its approval seal, jeopardizing more than $ 14 million in fund physician training. Approval of King/Drew approval was revoked in February 2005.
The move gained national attention after the Los Angeles Times carried out a series of five series of the Pulitzer Prize series reporting "The Troubles at King/Drew." The series found that the problems at the hospital were much deeper than the public knew and blamed the Supervisory Board for avoiding making the necessary changes, often due to racial politics. Among the other findings is that the King/Drew spends more per patient than the other three general hospitals run by Los Angeles County, the opposite of what many hospitalists have assumed.
The problem for King/Drew became worse for four days in March 2005, when three patients died as a result of mistakes and irregularities in medical care. The Supervisory Board considered severing hospital ties with University of Medicine and Science Charles R. Drew and partnering with other medical schools such as UCLA, USC or Loma Linda University. Then, in April Los Angeles Times reported the seventh death due to irregularities in hospital treatment. This time, nurses and staff almost ignored the audio and visual cues from the monitor of vital signs for several hours.
"Make-or-break" inspection
After three previous warnings holding the King/Drew of compliance with federal guidelines since January 2004, CMS and federal authorities conducted the last inspection without notice from the hospital that began on July 31, 2006 and finished on August 10. In September 22, CMS informed King/Drew that the hospital still had not met the minimum patient care standards, failing nine out of twenty-three government conditions for federal funding, and thus failing to "make-or-break" the final inspection. The federal regulator identifies problems in nursing, pharmacy, infection control, surgical services, rehabilitation services, quality control, patient rights and hospital management bodies and physical plants. Inspectors found more problems during the final examination than they did at any time in the previous three years.
Reopen and Remanagement
To curb the racial tension and the comforts of citizens in supporting hospital stays, President Obama initiated the plans for Obamacare to regain confidence and provide adequate care to potential clients. The federal government, under the supervision of independent private companies, allocates funds to rebuild and manage new facilities. King/Drew King/Drew King/Drew becomes King-Harbor
Radical restructuring
DHS was selected to move forward with a radical restructuring plan that removes hospital-specific services, severes its relationship with Drew's medical school, and proposes to place it under the management of Harbor-UCLA Medical Center (Harbor-UCLA). The plan is streamlined and refocused the hospital on public medical care, including emergency department and outpatient services; the two main pillars of the plan are identifying and eliminating underperforming staff and integrating two hospitals "under one medical management and administrative leadership team at Harbor-UCLA." King/Drew becomes King-Harbor to reflect change.
All hospital employees were interviewed, half were allowed to stay and the rest were transferred to another hospital. Approximately 1,400 employees have survived. As a result of these measures, Medicare agreed to continue funding the hospital until March 31, 2007. After further negotiations, the federal inspector agreed to suspend the examination until August 2007. The King/Harbor must pass this inspection. Otherwise, federal funding will expire on November 30, 2007. As part of a March deal with the federal government, Los Angeles County agreed not to charge Medicare for hospital services until August 2007, allowing time to fix problems at the hospital. If federal funding ends, among other problems, MLK-Harbor will permanently lose 250 medical resident slots, 15% of 1,700 in Los Angeles County.
On March 6, 2007, officials from the University of Medicine and Science Charles R. Drew announced that they sued Los Angeles County for $ 125 million for breach of contract, claiming that the hospital restructuring had stopped support for 248 medical residents and destroyed nearby universities.. Both entities have collaborated since 1972. In response, the Los Angeles County Board Supervisor Mike Antonovich stated "Drew University will fail in court because they failed as a medical school."
Issues appear again
Despite initially an upbeat official report from hospital officials, King-Harbor finds itself under public criticism once again after different stories run in both Los Angeles Times and LA Weekly the end of May 2007 cites serious irregularities in the treatment, one of them fatal, in the hospital renamed. In particular, the case of Edith Isabel Rodriguez, who died of blood loss on the floor of the emergency room after being ignored for forty-five minutes, became the cause of bureaucratic failure and indifference. King-Harbor and political and health leaders in Los Angeles, create or reinforce the fear that the health care system can not care for people in a time of great need. In response to public condemnation, the chairman of the Senate Finance Committee, Sen. Max Baucus (D-Mont.) Asked federal regulators to discuss how they would protect patients at King-Harbor in light of "horrible" and "horrible" deviations in patient care.
News reports encouraged multi-day examination by state and federal officials, and on 7 June 2007, federal health officials claimed that King-Harbor had placed emergency patients in "immediate harm" from harm or death, that it remained in violation of Emergency Medical Care and the Active Labor Act, and give it twenty-three days to fix the problem or lose federal funds once and for all. During the examination, the CMS found that 17 patients, among the 60 patients reviewed, received sub-standard care in the hospital. If the matter is resolved within that timeframe, the hospital can still lose federal certification for failing to meet the terms of the March agreement with the US Medicare and Medicaid Services Center. Despite various threats from the government, experts in hospital accreditation cite the government's relatively angry response due to the unique hospital history and special status in society, as well as the support of African American politicians.
On June 12, 2007, Los Angeles Times reported that King-Harbor had replaced the chief medical officer, Dr. Roger Peeks, who was brought in to fix the problem three years earlier. During the June 18, 2007 meeting with the District Supervisory Board, local health officials revealed that they were still unable to fulfill their basic pledge for the CMS: only about one-third of the 1,200 employees initially projected to be transferred to other agencies had actually been transferred, and significant controls have not been effectively handed over to Harbor-UCLA. In April, 60% of the 285 registered and licensed vocational nurses failed one or more parts of the basic clinical competence assessment; while more than 10% failed three or more parts of the assessment. The Harbor-UCLA staff was surprised by the amount of training the King-Harbor employees needed.
On June 21, 2007, the California Department of Health Services (CDHS) moved to revoke the King-Harbor license. The process, supported by state politicians including Governor Schwarzenegger, could take six months to a year and would force the closure of the hospital. CDHS may void action if the hospital can demonstrate that it meets state and federal standards. There remains serious concern about how 47,000 King-Harbor Department emergency visits may be scattered throughout the system with minimal disruption if the hospital gets shut down. In response to the country's decision, the Los Angeles County Superintendent considered the government to close the hospital in front of the state, hoping to formulate and implement a regular plan to divert patients and, by suspending King-Harbor instead of letting it lose its state. license, make the task easier to reopen it. The County finally decided not to move for County closure. The hospital received a brief delay when the June 25, 2007 examination showed a critical problem with its emergency department identified at the beginning of the month was fixed, maintaining federal certification and funding for the hospital until August 2007, when it had to pass through a broader federal review.
A week-long federal examination began on July 23, 2007. The next day, inspectors from CMS once again quote King-Harbor for putting patients in "immediate danger" of danger, hours after psychiatric patients cut themselves with a scalpel in the emergency department's bathroom.
Closure
On August 10, 2007, after the hospital failed to conduct a comprehensive review by the US Center for Medicare and Medicaid Services, federal officials decided to deprive $ 200 million in funding. The supervisors concluded that there were no quality improvement plans working in the hospital. Director of Los Angeles County Health Dr. Bruce Chernof moved quickly to inform the local Supervisory Board about his decision to begin closing the facility. The emergency department closed at 7 pm. that day and the ambulance was transferred to another county hospital. Another hospital was closed on August 27, 2007. Some 1,600 King-Harbor employees are likely to be reassigned to work in other regional facilities.
On August 13, at a special board meeting, LA County's supervisor voted unanimously to close the inpatient service and promised to pay up to $ 16.3 million to a nearby private hospital and doctors prepared to flood patients from closed facilities. They also released a 124-page report by a federal inspector detailing dozens of faults and failures by the hospital during their final make-or-break review. Excerpts include medical equipment that is not properly sterilized, nurses who can not quickly find drugs, nurses who do not know how to mix drugs in an emergency, and patients who complain of severe chest pain but are not given painkillers for four and a half hours.
With the hospital closed, the facility continues to operate as the Martin Luther King Jr. Ambulatory Treatment Center, an emergency care facility and an outpatient clinic.
Ramification closing
The King-Harbor closure has a direct effect on health care services in the region. Nine nearby hospitals were declared "affected" by the former King-Harbor patient distribution. The greatest burden falls at St. Medical Center Francis near Lynwood, which expanded its 14-bed emergency department and saw patients increase from 155 per day to 180 per day, with intensive care units seeing an average increase from 26 patients to 33. Clinics nearby were also affected. Nine clinics that are part of the Children's Well and Family Center St. John has seen a 157 percent increase in visits since King-Harbor closed. Meanwhile, the outpatient clinics left in King-Harbor have seen the number of patients fall well below the target of 190,000 visits a year due to the negative reputation of the facility. Since King-Harbor has long been a major hospital for the sickest and poorest urbanites, an increase in uninsured and under-paid patients has placed considerable pressure on the financial health of mitigation agencies. With hospital closures, South Los Angeles has one hospital bed per 1,000 residents, compared with the national average of three beds per 1,000 population.
Maps Martin Luther King Jr. Outpatient Center
New replacement hospital
As soon as MLK-Harbor was closed, efforts began to look for ways to reopen the facility as soon as possible. The Los Angeles County officials initially planned a reopening in 2009, but that proved to be unfeasible. County found a partnership with the University of California system to reopen the hospital as a nonprofit organization governed by a seven member board of directors; the hospital is no longer run by the county. The board of directors will consist of two persons selected by the university system, two selected by local officials, and three chosen jointly. County will contribute $ 50 million annually to cover expenses and operating expenses and $ 13.3 million per year for uninsured patient care. The district will continue to be staffed and operate a hospital outpatient service center, which remains open. The hospital, now called Martin Luther King, Jr. Community Hospital opened on July 7, 2015.
The new non-profit entity handles all recruitment for Martin Luther King Jr. Community Hospital. This has been a major point of negotiation because hospital staff have gained a reputation as politically connected people with elected officials, leading to criticism that problems with hospital staff tend to be ignored. At closing time, it has about 11.5 workers per bed, compared to the statewide average of four workers per bed. Civil service rules and employment contracts will require a former MLK-Harbor employee to be given the first chance at a replacement hospital if it is owned and operated directly by Los Angeles County. Surging a replacement hospital under Section 501 (c) (3) a non-profit organization makes it a different entity than County, unencumbered by the legacy of hiring rules.
The hospital reopened as a smaller facility, with 131 beds instead of 233 (compared to 537 at its peak). It has emergency department and four operating rooms. The UC system provides fourteen to twenty doctors and medical supervision for inpatient hospitals, with the ultimate goal of providing medical residents to re-train there. Other improvements are an improved central plant, a new emergency generator, and two new buildings, one with six outpatient operations and dental clinics, with an estimated total cost of more than $ 350 million.
Affiliated SMA
King Drew Magnet High School of Medicine and Science, located adjacent to the hospital in Willowbrook. This is a magnet school of the Los Angeles Unified School District affiliated with MLK Jr
See also
- Martin Luther King Jr. Community Hospital - opened on site in 2015 .
- Charles R. Drew University of Medicine and Science - contiguous .
- King Drew Magnet High School of Medicine and Science - close .
- African-American History in Los Angeles
- Related topics South Los Angeles
Note
References
External links
- Official website
- C-SPAN Questions & Answers; Interview with Tracy Weber and Charles Ornstein on "The Troubles at King/Drew", July 17, 2005
Source of the article : Wikipedia
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