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Editorial: Hospital troubles

Something's rotten in the City of Medicine. Six months ago, Durham Regional Hospital failed to meet quality standard for federal Medicare and Medicaid funding. Earlier this month, the hospital again failed to meet these quality standards. The initial violations were bad enough, but the fact that the hospital failed to follow up and correct these violations is a huge deal.

These violations include failure to give blood transfusions properly, major problems with the hospital's dialysis services, failure to treat patients' pressure sores and failure to complete proper health screenings. Additionally, flaws in the overall organizational structure of the hospital were found as well as problems with nursing care.

It's unfortunate that the hospital and the Duke University Health System have been unable to correct the errors that were revealed six months ago, although it is extremely difficult to understand why these errors have not been corrected. The hospital had six months to make basic changes and failed to do so, and if it does not make changes now, then they will lose their federal funding, which would be catastrophic for the hospital and its mission to provide a health service to the community.

One problem is the fact that DRH is not making money, largely because of the low reimbursement rates on Medicare. However, just because DRH is not making money doesn't mean that it doesn't have money. As part of DUHS, the University bankrolls DRH and covers their operating expenses. Therefore, DRH clearly had sufficient funds to make the necessary changes to ensure federal compliance, but for some reason, failed to make these changes. Additionally, the shortage of nurses also contributes to the hospital's problems, but this does not excuse the violations.

Right now, the hospital has about five weeks to get things together and make serious changes. Administrators of DUHS need to take a more active role in DRH and ensure that it complies with all the rules in the future. One surprising and disappointing aspect of the relationship between DUHS and DRH is the significant difference in quality between a hospital like Duke's and DRH. Duke has taken over DRH, but has not replaced the staff, so the challenge is to transfer knowledge from one hospital to another.

However DRH plans to address these violations, they need to be addressed immediately and the problem must be eliminated. It is unacceptable to have a DUHS hospital that cannot give proper care; it is dangerous for the patients and it reflects very poorly on Duke.


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