Honorable
Governor Edmond G. Brown Jr.
February 24, 2014
The Great State of
California
c/o State Capitol,
Suite 1173
Sacramento, CA
95814
Dear
Governor Brown,
Thank you
for your interest in patient safety, I really appreciated it. My advocacy for
the Prevention of Healthcare Associated Infections(HAI) in our Veteran’s
Administration Hospitals (VAH), according to the U.S. Department of Health and
Human services, a preventable disease, is devoted to supporting those who help
others, much like yourself, “thank you”! This letter was originally addressed
to Mr. Tom Garcia, Senior Field
Representative for the Honorable Assembly member Rocky Chavez, a fellow Marine,
after passively mentioning my advocacy to Mr. Garcia at a recent Chamber of
Commerce networking lunch, I commented about Assembly member Chavez’s commitment to supporting Veterans and he
asked me to provide more information about my advocacy and let me know that the
Assembly member Chavez is now on the health committee. Sorry about the length
and challenges brought forward, opportunity is upon us, please forgive my
direct approach, my time is limited, perhaps our common ground.
The impact
of HAI in our VHA , for the most part, is not reported, although there is
interest from several groups supporting more transparency. My only opportunity
to support the VAH is to improve the entire healthcare system in California via
“Best Practices”, a product of “evidence based medicine”, being collected and
posted in a “Database of Best Practices for the Prevention of HAI” at the
California Department of Public Health(CDPH), covered by the freedom of
information act, based on the concept of the U.S. E.P.A.’s Puget Sound Storm
Water Runoff Best Management Practices and challenged world-wide to be
continually improved and monitored by an already funded state of the art
monitoring system at the CDPH.
One hospital in California has not had a case
of Centerline Associated Bloodstream Infections(CLABSI) in nearly eight(8)
years yet thousands will lose life or limb per annum in California let alone the fiscal cost.
Let’s
consider a known “best practice” to prevent CLABSI, at the federal level the VA
is awaiting feedback concerning “best practices” from the USDHHS who are awaiting and
sometimes funding the development of
"best practices” at the state level, the federal VA will then advise the
regional VAH concerning “best practices”
who are also watching for state level developments.
The problem, California is not developing or
accepting “any” best practices for the prevention of HAI and the CDPH avoids,
at all cost, the term “best practice”. The only possible reason for the CDPH, a
fully California taxpayer funded entity, to not facilitate “best practices” is
their very cloudy relationship with the U.C. medical system, another asset of
the California taxpayers, they seem to share addresses and nearly all of their
staff have a history in the UC system.
Recently, one of the UC hospitals received an “F”, the lowest possible
score, for patient safety from the Leapfrog group, a privately funded
monitoring system, the CDPH monitoring system reports only if a facility is
improving or regressing with no indication of current status despite the fact
that they do collect the statistics. The fact that the U.C. medical system is a
“teaching” system, one excuse used to defend the poor rating, does not bode
well for the taxpayer or patients across the state. The CDPH’s claim that “more
than half of the CLABSI cases are preventable” virtually “green-lights” some form of socially acceptable statistics
concerning the needless loss of life and fiscal waste in our state. The most
profound impact of the lack of commitment at the CDPH to any “best practices”
is every healthcare facility has to create their own “best practices”,
replicated hundreds of times across our state, it is hard to imagine what
criteria is used to train staff or the entropy caused by budget cycles and
turnover.
Recently the Federal O.S.H.A. has declared an interest in developing and
adapting “best practices” concerning patient and workplace safety leaving the
efforts at the CDPH highly questionable
and virtually irrelevant.
The actual plan to combat HAI at the CDPH is
to use their monitoring system to identify failing systems and flood them with
staff and resources they do not have to bring them back to socially acceptable
statistics, how this will “prevent “ HAI
completely eludes common sense.
Organized labor is dong next to nothing in our
state concerning sending their members into a needlessly dangerous workplace,
the Honorable Governor Brown’s “Let’s get healthy California” is a good start,
HAI is prevented by a highly motivated and empowered healthcare staff member accepting
a leadership role in the implementation of a known “best practice”, nothing
more, nothing less and this will not happen without a commitment from organized
labor to educate and empower their members accordingly.
The CDPH has a legal responsibility to prevent
HAI, a preventable set of diseases, and should be much more aggressive
concerning patient safety verses their currently defensive posture, they need
to choose between protecting the bottom line of state assets or protecting
California citizens from preventable diseases and massive amounts of fiscal
waste in our healthcare system.
Do we have the “will” to prevent HAI, your
interest leads me to believe we do, the technology and “best practices” are
already there and once again, thank you for your interest and yes, the term
“Best practice” is the key, we have “control guidelines”, “guidelines for
prevention” and “recommendations” but never the term “best practice”, hopefully
you as the Honorable Governor will at least get the respect of an answer which
I have not receive in over two years of humbly asking the staff at the CDPH.
Respectfully,
cc:
Honorable
California Senator Ed Hernandez
Chair,
Committee on Health Care
Honorable California Senator Mark Wyland
Honorable
California Senator William W. Monning
Honorable
California Assembly member Rocky J.
Chavez
Honorable
California Assembly member Katcho Achadjian
Diana S.
Dooly
Secretary
California
Department of Public Health
Ms.
Kathleen Billingsley
Chief
Deputy Director
California
Department of Public Health
Ms. Debbie
Rogers, RN, MS, FAEN
Deputy
Director
Center For
Health Care Quality
Ms. Dana
Woods
CEO,
American
Association of Critical Care Nurses
SEIU-UHW
Executive
Board
Mr. Chuck
Idelson
Communication
Director
California
Nurses Association
Mr. Tom
Garcia
Senior
Field Representative for the Honorable Assembly member Garcia
Mr. Eddie
W. Hartenstrin
Publisher
and Chief Executive Officer, Los Angeles Times
Publisher
and Chief Executive Officer,Tribune Company
Ms. Pam
Kehaly
Chief
Executive Officer,
Anthem Blue Cross
Staff,
Anthem Blue Cross
"If we
can improve the quality of care, that will translate into lower cost,"
Anthem President Pam Kehaly said. "These are real dollars."
3
Happy kids, courtesy US Peace Corps
