Feds outline reforms for reservation hospitals

SIOUX FALLS, S.D. (AP) — Federal officials on Wednesday outlined a plan to improve care at hospitals that treat Native Americans in four Great Plains states, including creating a multi-agency group to focus on quality and patient safety and designating a single organization to accredit Indian Health Service hospitals.

 

The U.S. Department of Health and Human Services detailed the steps to The Associated Press ahead of a Senate committee hearing on Wednesday afternoon in Washington that’ll discuss the quality of care at IHS hospitals in the region.

The hearing and promised reforms come weeks after federal inspections highlighted serious problems on a pair of hospitals on South Dakota reservations and months after inspectors uncovered inadequate care for a man who died of kidney failure two days after seeking care from a hospital in Nebraska.

HHS Secretary Sylvia Burwell is establishing a group that will include leaders from IHS — which administers the hospitals that provide free care for Native Americans — the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention and other agencies. The group will address persistent staffing shortages and develop policy and training proposals to “bolster the safety culture,” HHS said, as well as provide immediate assistance to hospitals in need, focusing first on the Great Plains region of the Dakotas, Iowa and Nebraska.

“As part of that plan, the executive council will be charged with executing a rapid-response process, including deploying resources from across the Department when a facility needs immediate, systematic improvement,” according to the initiatives given to the AP.

Federal officials said using a single accrediting body would ensure “similar performance measures and expectations are applied across IHS hospitals” around the country. All accreditation surveys would then be reviewed annually to identify which hospitals and medical centers need the most help.

Another change is bolstering training for the boards and doctors who run the hospitals, and using “data analytics” to improve reporting and decision-making.

Earlier this week, federal authorities announced that a new acting director was assigned to the Great Plains Area office in Aberdeen and that they’ll deploy a four-member team to address problems at the hospitals in the Pine Ridge Indian Reservation and Rosebud Indian Reservation in South Dakota and the Winnebago Reservation in Nebraska.

In October, inspectors visiting the hospital in Pine Ridge in western South Dakota cited safety deficiencies including unlocked cupboards with syringes, needles and other equipment; unsecured drugs and medical records; an isolation room without gowns and masks; and doctors without proper credentials.

An inspection of the Rosebud hospital in November found conditions so alarming the emergency room was shut down. A patient having a heart attack wasn’t treated until 90 minutes after she arrived. Serious staffing shortages in the emergency room included vacancies for the supervising medical officer, a medical officer, two physician assistants and three clinical nurses.

IHS provides services to about 130,000 people through seven hospitals, 15 health centers and several smaller satellite clinics in the four-state area. At the emergency room in Rosebud alone, 6,595 patients were seen between May and October.

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