Mendocino Coast District Hospital's (MCDH) Board of Directors has canceled its monthly Planning Committee meeting for May. It strikes this observer as odd to cancel a chance to express a clear vision of future planning for a hospital in the final month before that hospital is asking the public to approve a parcel tax. It's a bit like a candidate not showing up at a forum to handle questions from the voters in the weeks leading to an election. It does not engender confidence.
A look back at the April MCDH Planning Committee get together offers further insight into how the leadership team at the hospital views and treats the public, even their own handpicked members of the public. The hospital leaders I am writing about are Bob Edwards, Chief Executive Officer (CEO), and Steve Lund, President of the Board of Directors. These two essentially run the planning committee.
The main agenda item at the April planning meeting was labeled, “Strategic Initiatives.” CEO Edwards passed around a seven page handout to those in attendance. As usual, his strategic initiatives are not available online. Edwards described his six most important initiatives as “pillars.” They were titled, in order of Edwards' preference: 1) “Quality/Delivery of Care;” 2) “Physical Plant/Facilities;” 3) “Financial/Fiscal Solvency;” 4) “People/Physician, Nursing and Support Staffing;” 5) “Community Engagement/Involvement;” 6) “Governance”
Pretty mundane, run of the mill headings. If you want to watch your own eyeballs roll back out of sight, stand in front of a mirror and get a load of what is written underneath the “Quality/Delivery of Care” heading:
Joint Commission, 2nd or 3rd quarter 2018
BETA, Annual, May 19
Prime, Annual, Oct 18
CMS, Ongoing, Unannounced
ACHD, April 18, April 19
NRC Health (HCAHPS) Quarterly
Yes, acronym city. They are all abbreviations for entities that review part or all of the hospital's workings. A member of the public who was part of a subcommittee to put together these strategic initiatives wrote this: “If for public use... Include a glossary of acronyms: Acronyms that aren't familiar don't educate, they keep the reader at a distance, which goes against goals for transparency and educating.”
That same member of the public also stated, “The audience for this document is unclear. As is, it doesn't speak to the community outside the hospital. Public buy-in going forward means addressing people in everyday language and out in their arena. This is not just a planning exercise. Everything done from now on is critical to the future of the bond measure and keeping patients here. Anything that distracts or distances the public, the voters, or drives patients over-the-hill unnecessarily can negatively impact the hospital's future.”
As that member of the public most likely figured out by the time Edwards was done shambling through this mess of acronyms and abbreviations, the document was not truly meant to see the light of full public airing, but merely as something to show bureaucratic auditors, inspectors, and regulatory review teams. As part of this hoodwink, the CEO and MCDH Board President needed to create the appearance of public participation in the process of strategic planning for the hospital.
The member of the public quoted above described how the process worked for her: “Four public members were asked by Steve Lund to be part of a Planning subcommittee on a strategic planning effort. We met twice for one hour each time. For the second meeting the Draft information was arranged into a more traditional format a member suggested. Despite other, sometimes extensive comments, questions, and suggestions by the public members, none were addressed at our second and last meeting. There was no real discussion of our comments, nor clarification of anything in the Draft, nor an answer to the question of what was expected from our participation. We expressed concerns for the lack of public engagement focus in the draft – an emphasis when inviting us onto the subcommittee. We also gave assurances, if done properly, a public planning process could be successful. The virtually unchanged document has moved on a fast track to the [MCDH] Planning Committee. The missed opportunity is [for] those who were invited to the table (and others in the public) [who] have expertise and success at planning and management including in a major hospital. In short we've earned our stripes.”
Not much more need be said. It is clear that Mendocino Coast District Hospital's Chief Executive Officer and its Board President see the public, even their own hand-picked part of the public, as mere tools, and abbrev. ones at that.
Some real planning for MCDH's future should look more like what Dr. Peter Barg sketched out within a recent letter to the editor opposing the hospital's parcel tax ballot measure. “[A] reasonable concept moving forward might be for the District to oversee expanded outpatient care that would provide rapid access to providers at all levels; routine, urgent and emergent. (The Emergency Department is exactly the same size it was 48 years ago when the Hospital opened). A triage system would be put in place to establish the level of care needed and direct people accordingly. In addition we would need an expanded transportation system including shuttles, ground and air emergency by contracting with various existing agencies to get patients to the right place for the best care in the most expeditious fashion. Finally, there should be an overnight holding unit for stabilization or prior to transfer and for people undergoing scheduled outpatient procedures.”