Even as District of Columbia officials struggle with deepening woes at the United Medical Center (UMC), advocates from a national, independent, and nonprofit group have offered a dim review of hospitals in the DC area.
The bad news keeps piling on at UMC, a leading provider of medical care for communities of color in the District’s Southeast area and in Prince George’s County, Md.
To its credit, the sometimes locally slumbering Washington Post has put out a disturbing, well-documented report about the death of a 47-year-old HIV-AIDS patient in UMC’s nursing home care. As others witnessing the scene clamored for them to help, UMC nurses, the Post says, let the patient fall to the floor, where he sprawled in his own waste for 20 minutes while his caregivers argued with a security guard. When the patient finally was returned to his bed, he was dead.
The paper says that UMC fired the nurses but failed to inform regulators about the incident. The patient’s family has complained the hospital misled them about the circumstances of their loved one’s death. The UMC-filed death certificate said the patient died of a heart attack, but that report did not carry any mention of potential “injury, neglect, or abuse,” the Post said.
District officials and the independent body that accredits UMC have expressed displeasure about the hospital’s failure to report the incident, as experts say it legally should have.
This death occurred after regulators recently had shut down UMC’s obstetrics operations for at least 90 days, ordering the hospital to remedy issues discovered in some incidents of poor and negligent care. The Post also has reported how a family complained that the hospital didn’t tell them their 70-year-old dad had died in its care, and then lost his body for several days.
The political furor over the hospital has focused on Veritas, an independent hospital management company that is well-connected to local politicians and has received a multiyear, multimillion-dollar contract to try to turn around UMC. Veritas has fired the hospital’s CEO, who, along with the management firm and other institutional leaders, just was battered by a vote of no confidence from members of UMC’s nursing staff. DC council members also have indicated their unhappiness with Veritas, suggesting it should lose its UMC contract.
The hospital’s chief medical officer and former quality management and safety officer both have joined to assail Veritas, saying it put its own interests in keeping a lucrative contract to run the public hospital ahead of patients’ safety and care.
DC Mayor Muriel Bowser (shown above) also has announced that an independent George Washington University Hospital doctors group, the largest of its kind in the area, starting around the new year, will take over the operations of UMC’s emergency room. The mayor hasn’t provided specifics about this deal.
The politicking and tumult surrounding the hospital needs to significantly improve its medical services and patient care, of course—and this all hurts people and communities already struggling and vulnerable. The Post, again, describes how the eastern half of the district has been staggered by various, seemingly unrelated events and factors that have slashed at the availability of medical services in the area. The loss of women’s and maternal health services is grim, especially as the nation as a whole struggles with the “dreadful reality” that the United States, alone in the developing world, has such high rates of maternal deaths.
The woes, not just at UMC, but also at the MedStar Washington Hospital Center — which USA Today has reported is plagued by under staffing, personnel turnover (especially among its critical force of nurses), and maintenance and sanitation problems — indicate that the poor in the District may have poor access to quality hospital care.
Indeed, though Washington may be a seat of global political might and home to formidable medical research institutions like the various facilities of the National Institutes of Health, the area’s hospitals keep getting low ratings from watchdog groups.
Although experts may raise an eyebrow at how much it allows institutions to self-report its key data, the Leapfrog Group, in one of its periodic safety assessments, has raised tough questions about the poor performance at hospitals in the District, Maryland, and, to a lesser degree, Virginia.
The group gave UMC and Howard Hospital an F grade, while dinging with D grades Providence Hospital, MedStar Washington Hospital Center, and George Washington University Hospital. Leapfrog graded MedStar Georgetown Hospital a C, while Sibley Hospital rated a B. (Click here to get to the online details on the DC hospitals. Virginia hospitals did better and you can click here to see information on them.)
Leapfrog, which is a consortium of major employers nationally dedicated to improving hospitals, long hadn’t graded Maryland hospitals because they declined to participate, largely due to their operation under an unusual federal agreement. This year, the group did so for the first time. (Click here to get to the full information.) And as the Baltimore Sun reported:
Maryland hospitals rank near the bottom nationwide when it comes to avoiding medical errors, accidents, injuries and infection … Only one of the state’s 44 hospitals, Howard County General Hospital, earned an A, while seven received a B. The majority earned a C, while eight got a D and one — Bon Secours Hospital in West Baltimore — received an F.
In my practice, I see the significant harms that patients suffer while seeking medical services and their huge challenges in finding safe, accessible, affordable, and quality medical care. Hospitals play a crucial role in this, of course, so much so that the firm’s site carries a convenient, fast map of institutions throughout the area and details on how, based on federal govern data, they can be rated in various aspects of their care. Clearly, for those who live in the area and for our leaders and boosters, we have a long way to go to ensure that area hospitals are simply the best they can be.