Sunday, June 19, 2011

Why Alameda Hospital is Inferior

Here's the problem.  Alameda Hospital is not a lousy hospital, but people think I am saying that.  What I am saying is that Alameda Hospital is incapable of delivering consistently superior outcomes (or even adequate outcomes) in the acute care setting.  Michael Jordan FAILED at becoming a baseball player which was his dream.  He had all of that athleticism; all of that money; all of that desire and he FAILED. 

Yet nobody would assess Jordan's career and focus on his failure unless he would have stubbornly insisted that he would not give up; that he was a great baseball player; and never deviated from that opinion.  The Board majority is exactly that blind when it insists that no change is needed to emergency and acute care services at Alameda Hospital.

What makes a Hospital great:

1.  Exceptional clinicians is one aspect.  Although every single physician at Alameda Hospital is licensed and many/most are Board certified, they are not exceptional.  None of them are tops in their field.  Certainly the care is adequate, but nothing better than you will receive at Alta Bates (18-19 minutes away even without sirens),   San Leandro or Eden (19 or 22 minutes away respectively), or Kaiser ( 16 minutes away) or Highland (13 minutes away).  In fact, if you are having a neurological problem, the level of care available at Eden is much higher.  If you are a trauma victim, then I don't care how scary Highland is, you want to go there.  And if you are having a serious heart attack (what is known as a STEMI), then the EMT's better take you to Alta Bates-Summit.

2.  Technology.  More and more, care is dependent on technology.  Alameda Hospital is in the process of upgrading its technology, but technology costs money and the Hospital is not capable of keeping up in this area because of its finances.  In addition, because of its size, the costs -  for the exact same equipment - are higher because Alameda Hospital is in a poor negotiating position with vendors.  For example, Alameda Hospital paid between 5-6 thousand dollars for every mobile workstation (computers on wheels or COWs).  This was significantly higher than other hosptials I am aware of.  Other initiatives that are going to cost more and/or go slower are things like computer physician order entry, barcoding medications, and advanced imaging technology (even though the PACS is finally up, there are more advances, features, and modalities that Alameda will not have available to it full-time).

3.  Resources.  A Hospital that is not struggling is one that has the ability to respond to challenges like seismic retrofitting.  Remember, Alameda Hospital has been out of compliance with sesimic requirements since 1/1/2002 and has no established plan to correct that deficiency much less the structural aspects of the seismic law which were originally due 1/1/2008 but have been extended multiple times.  Also, morale, quality initiatives, and regular maintenace suffer when an organization is always, always struggling.

Next Board meeting, once again the Board majority will vote to impose a $298 per parcel tax on Alamedans that yields no benefit to the community as a whole in terms of better health.   The only thing that will convince me otherwise is evidence (not anecdote).  I have asked repeatedly for such evidence, but none has been forthcoming.

No comments:

Post a Comment