A whistleblower report was recently released alleging a myriad of issues within the UC Medical System that are supposedly detrimental to patient care.
The report, titled “A Question of Priorities: Profits, Short Staffing, and the Shortchanging of Patient Care at UC Medical Centers,” was released by AFSCME 3299, the statewide union of University of California service and patient care workers. It compiles a list of concerns about practices at the five centers that make up the UC Medical System: UC Davis, UC Irvine, UCLA, UC San Diego and UCSF. These concerns were brought forward by patient care advocates, independent investigations and frontline care workers at the medical centers.
The main problem alleged in the report is a fundamental shift in priorities in the UC Medical System, leading to a decrease in proper patient care.
“The biggest problem that needs to be addressed is the problem of priorities. There’s been a culture shift that is a result of the policy passed a couple years ago that gives budget autonomy to each medical center,” said Kathryn Lybarger, president of AFSCME 3299.
The UC Medical System earns $6.9 billion a year in operating revenues and millions in profits, according to the report. With each medical center keeping and controlling the money it brings in, the report states that there is incentive for management to run medical centers as individual profit centers instead of state institutions. Efficiencies, or cost-cutting measures, have been implemented across UC medical centers, but the report claims that many of these efficiencies are saving money at the cost of serving patients.
UC spokesperson Steve Montiel said UC is at a standstill with the union in negotiations regarding contracts.
“[AFSCME 3229] has a habit of trying to negotiate contracts in the news media rather than at the bargaining table. We have reached an impasse in negotiations and this is nothing more than a tactic to try to gain bargaining leverage. Our medical centers are some of the best in the country, with high-quality coverage and very high-quality treatment,” Montiel said in response to the report.
The university is still in negotiations with AFSCME 3229, according to Montiel.
Union workers have been attempting to gain the attention of management at medical centers for some time and put together the report in hopes that it may serve this purpose, according to Lybarger.
The report includes a number of accounts — from independent reports, inpatient discharge data and frontline care providers — that raise concerns about not only the quality but also the safety of care given at the medical centers.
Instances of patients falling when trying to go to the bathroom and dried blood being left in the crevices of operating tables are mentioned in the report. Lack of sanitation can lead to dangerous infections in patients.
“Some of the examples are really egregious,” said Todd Stenhouse, a member of AFSCME 3229.
The report highlights Findings of Immediate Jeopardy, which according to the report is defined by the State of California as “situations in which the licensee’s noncompliance with one or more requirements of licensure has caused, or is likely to cause, serious injury or death to the patient.”
Instances in the report include a sponge being left in a patient post-operation and a surgical incision being made in the wrong eye of a patient.
“Patients and their families suffer devastating consequences when infections occur during hospitalization. My own daughter suffered this fate and was left permanently disabled for the rest of her short life from a surgical site infection. I have personally witnessed the lack of cleanliness and surface disinfection that is needed in any healthcare setting,” said Julia A. Hallisy, founder and president of the Empowered Patient Coalition, in an email interview.
Understaffing is also an issue listed in the report.
“Bedside staff no longer [have] the time to comfort and educate their patients, which leaves them frustrated and questioning whether or not they want to stay in their profession. They have lost the joy that should be an integral part of being a healthcare provider,” Hallisy said.
The report also claims a lack of adherence to sanitation standards and VIP care being given to some patients over others. Financially, the report highlights a disproportionate amount of funds going to management income and hiring, while frontline care workers are being cut. There is also a focus on building new facilities when current ones are not being properly maintained, according to workers, advocates and AFSCME.
The report claims that all of these larger issues boil down to one thing: a shortchanging of patient care.
“We are not opposed to growth, but growth at the cost of patient care is not OK. It’s hurting real people,” Lybarger said. “The lack of care results in compromising patients’ dignity and maybe threatening their lives.”
A set of recommendations was offered in the report, focused around increasing oversight (with legislative hearings) and implementing more investigations by the California Department of Health. The report also calls for an increase in training to improve staffing and safety standards.
It remains to be seen if any changes will be made in the UC Medical System because of the report.
LAUREN MASCARENHAS can be reached at firstname.lastname@example.org.