UTSW and Parkland were tapped to operate a new Ebola treatment center, despite their track record of infection control failures. The center will be housed in an intensive-care unit at the Methodist Campus for Continuing Care in Richardson.
A Texas health panel’s decision to entrust the operation of a new Ebola treatment center to two Dallas medical institutions with a record of infection control failures has triggered questions from concerned national health-care experts.
They want to know whether Gov. Rick Perry’s Task Force on Infectious Disease Preparedness and Response even considered that recent history before installing them at the helm of the Richardson facility.
Until late last year, Parkland Memorial Hospital and UT Southwestern Medical Center were at the center of rare government safety intervention to try to fix what regulators called life-threatening breakdowns in infection prevention and other practices throughout Parkland, Dallas’ safety-net hospital for the poor. UTSW manages clinical care at the facility.
Regulatory violations have ranged from poor hand washing to filthy patient rooms with overflowing trash bins, excrement and blood. Turf battles between the two organizations over money, physician staffing and their divergent missions also have been factors in jeopardizing patient care over the years, we found in our own 2013 investigation.
But state officials aren’t saying whether the regulatory problems or the stormy partnership came into play during the rapid creation of the Ebola center in recent days.
Perry’s Texas Health and Human Services Commission, which helps coordinate the task force’s efforts, declined to answer questions about the decision, only giving the institutions a vote of confidence.
“They already have been training for the strict infection control procedures needed to handle a patient with Ebola,’’ a spokeswoman said.
Dr. Ashish Jha, associate professor at Harvard University’s School of Public Health, said the public needs an explanation.
“This track record of problems is of course concerning,’’ Jha said “A big question is have they (Parkland and UTSW) really put these problems behind them, and do they understand what caused them? It’s absolutely important for them to address this publicly.’’
“You would assume that the task force recognized the recent history and concluded that the two organizations will be able to work beyond past differences,’’ said Ranga Ramanujam a Vanderbilt University professor who studies organizational factors related to patient safety. He wants to know more about the decision process, he said.
Last year, the U.S. Centers for Medicare & Medicaid Services did free Parkland from two years of onsite safety supervision after the hospital spent nearly $100 million on reforms to remedy problems, replaced its top executive team, and passed a sweeping inspection. UTSW doesn’t answer to CMS for Parkland violations because it is not the actual hospital license holder or the direct recipient of government funds for the facility.
But Parkland remains under close scrutiny by state regulators under a settlement period stemming from a record $1 million fine for its infection control lapses and other failures. And it is due for yet another surprise comprehensive inspection following other patient-care breakdowns in recent months inside Parkland’s psychiatric ER. That looming inspection also will examine the hospital’s progress in remedying infection risks – perhaps the first real test of whether the fixes have been sustainable.
The hospital and UT Southwestern have repeatedly refused to talk about what they have done to address their history of bitter relations, which executives for both institutions have at times characterized as a “cage match’’ and marred by “vitriol.’’
That stance didn’t change on Wednesday. They issued a joint statement praising their “70-year history of working as partners and a productive and constructive relationship.’’
“Any assertion to the contrary is simply incorrect,’’ the statement said. “As we face this public health crisis, now is a time for unity, and we would hope that everyone would support this effort.’’
Jha, who has previously criticized a lack of transparency from Parkland, said that statement falls severely short. Both institutions risk eroding the public’s confidence even more by staying mum about details of their relationship, he said.
The stakes are even higher, given the Ebola crisis and national attention. They shouldn’t fall into the trap that Texas Health Presbyterian Hospital of Dallas did, he said. The lack of transparency by Texas Health was “shockingly bad in terms of management,’’ Jha said.
“You want to create a certain level of confidence with the public,’’ Jha said. “You want to be forthright about each other with the public and what you’ve learned.’’
Ramanujam agreed. He called the effort to channel several organizations’ resources – The Methodist Health System is volunteering the facility – into creating a new Ebola treatment facility “a welcome and logical solution.”
“But for this new Ebola center to work, effective coordination is critical,” he said. “As recently as a couple of years ago audits found serious problems in the how UTSW and Parkland were coordinating their activities. It is unclear how much progress has been made in addressing these problems.’’
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