Care clash - Page 2

UC hospital workers allege unsafe working conditions

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A flyer addressing UCSF Medical Center CEO Mark Laret -- the text reads "Layoffs Hurt Patient Care and Families"
POSTER DESIGN BY SETH NEWTON PATEL


DANGEROUSLY LOW STAFFING LEVELS?

Billed as a "whistleblower report," AFSCME's 40-page publication portrays an internal environment throughout UC medical centers in which staffers — particularly frontline workers — are exhausted, overburdened, and dangerously likely to make mistakes.

Peppered with anecdotal horror stories describing things like dried blood observed on operating room tables at facilities where custodial staffing was cut to a bare minimum, or an incident in which a mentally altered patient was found on a window sill at a medical facility where harrowed nursing assistants' attention was divided too many ways, the report portrays an unsafe environment that seems out of sync with the system's reportedly healthy earnings derived from patient care.

"Bring it up at bargaining, and you get told to kick rocks," said union spokesperson Todd Stenhouse. AFSCME has called upon state agencies and lawmakers to investigate UC policies on "cutting costs, reducing staff, and maximizing revenue."

"We've been getting lots of reports about short staffing, and no coverage for breaks," said Tim Thrush, a diagnostic sonographer who works with patients experiencing complications in pregnancy, and has worked at UCSF for years. "If you get a break or a lunch, it seems to be rare — even though it's state law." Thrush added. "It looks to us ... that UC's response to us raising concerns ... is to say, OK well then let's make it worse. Let's lay off a whole bunch of people.

"It's been very disappointing," he said, "and it's getting to be kind of scary."

The report emphasizes California Department of Public Health findings of violations relating to bedsores from 2008 to 2012. The sores can occur if a patient stays in one position for too long, causing reduced blood flow and damage to skin tissue, and have been linked to infection.

Among those affected by the layoffs were "lift and turn team" members, including care workers tasked with turning immobilized patients to prevent bedsores.

Ironically, Rush-Monroe, the UCSF spokesperson, noted in response to a Guardian query that a $300,000 "incentive pay" bonus CEO Mark Laret received in 2011 was based on multiple "clinical improvement goals" that had to be satisfied in order to qualify for the 2011 compensation increase. One of these targets was a reduction in the number of hospital-acquired bedsores.

While the union report points to rising instances of bedsores, and the UCSF administration claims they were reduced to the extent that the CEO was monetarily rewarded for the accomplishment, a quick look at scores on hospital ranking website California Hospital Compare showed that pressure sore rankings at UCSF are almost exactly even with the statewide average.

Meanwhile, hospital rankings of patient safety indicators on Health Grades, an online consumer ranking website, didn't reflect any dramatic differences between patient safety scores at UCSF, CPMC or Kaiser Permanente.

QUESTIONS RAISED

In the midst of these staffing cuts, AFSCME charges, the $6.9 billion system has enjoyed robust finances, with UCSF earning $100 million in net revenue last year. Between 2009 to 2012, management positions increased by 38 percent system-wide, while payroll costs for managers grew by 50 percent, with an additional $100 million a year allocated to administrative staffing.

According to a 2013-14 budgetary report prepared at the UC level, the system's network of public universities have suffered deep financial cuts while its five medical centers "have continued to flourish and grow," and "enjoy robust earnings."

A revenue breakdown in the UC budget report shows that 62 percent of medical center earnings system-wide were derived from private health care plan reimbursements, while about a third came from Medicare and MediCal, funded by the federal and state government.