Thursday, March 17, 2005

Cambio Healthcare Solution’s Twelve-Steps to Quality Care

When policy makers use the term “quality healthcare” what they are really talking about is the absence of bad outcomes, deaths, dismemberments, lawsuits or citation provoking mistakes. So has Cambio’s management caused a crisis of quality at the medical center? Yes. So how did they make the medical center dangerous? Well, actually they used a twelve-step approach.

The first step was to cut staff, and to replace highly skilled clinicians with temps in critical care areas. You want the nurse in the intensive care area to know where the “crash cart” is. If half of the ICU staff flew in from the red states the night before, not only do they not know where things are, they don’t have anyone to ask. The medical center doesn’t have enough oncology nurses, chemotherapy treatments are being delayed, this is a big no no, and will definitely get the hospital cited.

The second step: ignore maintenance in important areas, while spending extravagantly in others. Like why spend money on things like computers for doctors orders, telephones for nursing stations and patient’s rooms and elevators when you could blow millions on time clocks and PR. So under Cambio’s tenure, elevators have actually crashed down the shafts, when telephones break they don’t get replaced and computers, which generate physician’s orders for whole departments, are broken for weeks at a time. What is the point of clocking employees in if they don’t have any work because the computer broke?

The third step, keep executives away from all patient care areas, don’t articulate any long term vision for the hospital and blame employees and indigent patients for the hospital's financial problems. “Cambio doesn’t want these people in the hospital.”

So, while Cambio Healthcare Solutions failed to articulate a vision for the medical center, they have hurt patient care through cuts, bad staffing strategies, failure to maintain essential equipment and a negative attitude toward our clients. Once a consulting company causes this kind of damage what do they do? They claim victory having reined in cost and moved the facility toward “fiscal responsibility.” At the end of a consultant contract not much gets done. The Tennessee temps are busy keeping their chairs warm and trying to hire their buddy’s into high paid management spots before they fly home.

In the interest of getting a decent night’s sleep, I will skip the last nine steps of Cambio’s twelve-steps to getting blood from a stone or a public hospital. Still these consultants will be leaving on a high note; doctors, unions, managers, politicians and board members all express giddy optimism about the consultant’s departure. Everyone wants a real CEO. Awareness about healthcare has changed as well; people expect a functional public hospital. Medical center employees enjoy a new level of support and respect in the community and employees, patients and Alameda county residents expect the board of supervisors to make good on the promises of Measure A.

6 comments:

Anonymous said...

First, I want you to know how much I look forward to your column. My question: Is there any performance review of Cambio as they prepare to leave? Is there any consequence for their failure to produce as promised in some areas? I believe there should be a public accounting of their successes and failures tied to their compensation. Perhaps a farwell assembly, similar to the assemblies held when they arrived would be imformative. Employees could hear first hand from Cambio how much the situation at Highland has improved.

Bradley Cleveland said...

It's timely that you should ask about a performance review of Cambio. Although the agenda hasn't been published yet, next Tuesday, March 22, the Board of Trustees is scheduled to review an evaluation of Cambio done by Trustees Phan and Weinreb.

The evaluation was originally scheduled for last month in closed session, but County Counsel agreed with SEIU Local 616 that the Trustees would violate the Brown Act if they evaluated Cambio's performance in closed session. The Brown Act requires public boards to do the public's business in public.

Trustee meetings are usually held in Classroom A at Highland, with the open session beginning around 5 pm. If you work at the Medical Center, an agenda should be posted somewhere (at Highland, check the door at E-3).

If you are so inclined, you can get the agendas emailed or faxed to you by contacting the clerk of the board: (510) 437-8468.

Anonymous said...

WELL THE TENNESSEE TITANS ARE FINALLY GOING TO LEAVE ON THIS NOTE"YOU ALL ARE SUCKERS" AND THEY WILL GET THEIR PROPOSAL TOGETHER AND FIND A ANOTHER HOSPITAL TO BLEED. DO YOU THINK IT MATTERS IF THEY ARE ACCOUNTABLE, THEY MADE THEIR MONEY AND THEY KNOW WE THE MEDICAL CENTER IS VERY ANXIOUS FOR THEM TO LEAVE WITH OUT A QUESTION OR AN INVESTIGATION, THEY OWES US NOTHING BUT A MESS OF TURMOIL FOR THE NEXT GROUP OF EXECUTIVES TO PULL THEIR HAIR OUT. REMEMBER ITS GOING TO TAKE YEARS TO CORRECT OR CLEAN UP WHAT CAMBIO HAVE SCREW UP. PROBABLY OUR GREAT GREAT GRAND KIDS WILL FINALLY SEE THE UNDO OF THE DESTRUCTION OF CAMBIO. PERHAPS WE NEED TO CHAIN CAMBIO HERE TO HIRE THEM ON STAFF IN DIETARY AND HOUSEKEEPING DEPARTMENT TO HELP PAY BACK SOME OF THE MONEY THEY LEACH OFF US, AND FAR AS LIVING QUARTERS I KNOW A GREAT MOTEL ROACH TEL IN EAST OAKLAND THEY CAN STAY AT FOR 125.00$ A WEEK WHICH THEY PAY WHEN THEY OFF, THEY CAN COLLECT CANS AND BOTTLE IN EAST,& WEST OAKLAND RED LIGHT DISTRICT. THEY MAY HAVE TO FIGHT WITH SOME OF THE HOMELESS PEOPLE WHO WE TREAT HERE AT THE MEDICAL CENTER. NEVER THE LESS CAMBIO SHOULDN'T GET OFF THAT EASY!

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