D.C. hospital crackdown shows how patient safety information stays secret

umc-pic-300x111Health officials caught expectant mothers, local politicians, and the D.C. community off guard by ordering the only full-service hospital in the southeast part of the District of Columbia to stop delivering babies and to shut its nursery for 90 days.

Details weren’t provided as to why D.C. regulators slapped restrictions on United Medical Center’s obstetrics and nursery care license. The hospital itself has acknowledged that at least three incidents, which it says it cannot discuss due to rigorous federal patient privacy rules, prompted the official rebuke.

This shutdown provides a harsh reminder just how little the public gets to know about important issues affecting doctors, hospitals, and patient safety and quality care.

United Medical Center serves some of the Washington DC area’s poorest patients, and long has struggled with its finances and public perceptions about the accessibility and excellence of its care.

As the Post has reported about the hospital:

Built in the 1960s, the facility that was once called Greater Southeast Community Hospital entered bankruptcy almost 20 years ago. Since then, it has been run by a string of different operators. City officials have injected regular infusions of cash to keep the hospital afloat and have paid various consultants to overhaul its operations. This past spring, there was a new stretch of financial turbulence brought on by billing errors.

Still, United Medical Center boasts that it holds a “gold seal,” meaning it has met the “highest national standards” for the safety and quality of its care as determined by the prestigious Joint Commission, which evaluates and accredits more than 18,000 health care institutions nationally. The commission, as recently as 2014, inspected and deemed the 350-bed facility in “full standards compliance.”

Local broadcast reports suggested old, unclean facilities and issues with nursing care may have led D.C. officials to discipline the hospital, which may have its obstetrics and nursery license reinstated if it remedies the undisclosed issues before the three-month discipline.

Politicians expressed shock and concern about the sudden move, demanding that health regulators explain quickly their action, and asking whether women living east of the Anacostia River could get good, convenient obstetric care. District health officials and the hospital both say there are plenty of reasonable options in other facilities relatively close.

In my practice, I see the major harms that patients can suffer while seeking medical care, especially as careful study after study finds medical errors as a major cause of avoidable injury and even deaths. Experts are reporting that preventable medical errors cause 658 deaths daily in hospitals, nursing homes, and other caregiving facilities, making this the third leading cause of death in the United States (trailing only cancer and heart disease).

Patient safety advocates long have insisted that doctors, hospitals, and other care giving facilities must be much more open about their quality and safety issues and performance, for example, by forcing accrediting groups like the Joint Commission—which are established by and paid for their oversight—to publicly disclose their inspection results and findings. The Obama Administration had proposed, through the Centers for Medicare and Medicaid Services to require this transparency. But the agency, which has huge sway with its huge health funding, withdrew this plan under the Trump Administration, and CMS will let accreditors keep their hospital inspection secret.

That’s a wrong course for public policy—and the shift occurred even as experts in Baltimore at the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine called for national and transparent standards to improve quality reporting by health care organizations. Such measures and more are urgently needed, the physician-researchers write, “to allow the public to determine whether [safety measures] and data are truthful, timely, and transparent.”

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