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Are Million Dollar Plus Business Trained Managers the Right People to Lead Health Care in the Time of Ebola?

By       Message Roy M. Poses M.D.     Permalink
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Reprinted from hcrenewal.blogspot.com

You can guess my opinion on the answer.

Introduction

News and opinions about Ebola virus are swirling around the US, fueled by a tragic epidemic in West Africa, and fears that more infections could appear here. On October 6, 2014, I posted my concerns that despite a tremendous amount of confidence expressed by government officials and health care leaders, our dysfunctional health care system might have trouble containing Ebola virus. Less than two weeks later, my concerns do not seem so extreme. The first patient to be diagnosed with Ebola virus in the US has died. Two nurses who cared for him now have the virus.

There seem to be millions of words on paper and on the internet about Ebola appearing every day. So I certainly do not want to try to deal with the problem in all its aspects. I do want to revisit a particular set of issues from my October 6 post: the hazards posed by generic management deluded by business school dogma running health care institutions in the time of Ebola. In particular, my focus is the management of the US hospital at which one patient died, and two nurses were infected, based on what has come out since October 6.

The Incoherence of Hospital Leaders

On October 6, we noted that the hospital, Texas Health Presbyterian, part of the Texas Health Resources hospital system, had issued conflicting and confusing statements about why the first Ebola patient, Mr Thomas Eric Duncan, was sent home from the hospital when he first presented. The first specific statement by hospital managers was that there had been a problem with the hospital's electronic health record (EHR), as had been suspected by my fellow Health Care Renewal blogger, InformaticsMD. Then the hospital retracted that statement, but provided no explanation with which to replace it.

Since then, there have been more inconsistencies in statements made by hospital managers.

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Fever or No Fever?

First hospital managers said Mr Duncan arrived without a fever, but then review of his medical records indicated his temperature was as high as 103 degrees F while he was in the hospital, a fever high enough that it might reasonably have prompted admission given his other symptoms, even if Ebola was not a concern. (See this Dallas Morning News story.)

Readiness for Ebola Patients?

Hospital managers assured the public they were ready for Ebola virus patients, e.g., in the Dallas Morning News story of September 30, 2014,

When Ebola arrived, they were ready.

The staff at Texas Health Presbyterian Hospital of Dallas did a run-through just last week of procedures to follow if the deadly virus landed in Dallas.

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https://vivo.brown.edu/display/rposesmd

Clinical Associate Professor of Medicine at Brown University, co-founder Health Care Renewal, and President of FIRM - the Foundation for Integrity and Responsibility in Medicine, a not-for-profit organization (NGO) designed to raise (more...)
 

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