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.