SYN. NO. AGN. NO.

MOTION BY SUPERVISOR GLORIA MOLINA January 19, 1999

The Department of Health Services has undergone dramatic changes in the last several years to improve services and prevent medical malpractice claims.
Priorities have been, and continue to be, thorough reviews of medical malpractice claims, creation of corrective action plans and their timely completion, and the implementation of new medical policies.
Board oversight has taken us from cursory reviews of claims to comprehensive corrective action plans that must be completed whenever a medical malpractice claim comes before this Board for approval.
This oversight has taken us from a lack of accountability at the facility level to the addition of an Associate Director of Medical Affairs within the Department who holds every staff member accountable for negative outcomes, at every level, from the medical resident to the Department Chair. It has expanded facility reviews, ensured implementation of new policies and procedures that must be adhered to as a result of new protocols.
Scrutiny and attention to medical malpractice issues have not been limited to the County. During the last legislative session, Senator Martha Escutia introduced a measure which, had it been approved by the Governor, would have placed greater accountability over obstetrical cases resulting in a negative outcome. The measure would have attempted to require every hospital in the state to produce corrective action plans for obstetrics cases. I do not think we are immune to such attention again in the future.

As a Board, we also confront increased legal costs with risk management processes that are delayed, negative outcomes that are reviewed two, three and up to four years after the original incident. Further, responsible staff often cannot be disciplined because the incident occurred several years ago.
I am pleased to share with you that, with the assistance of County Counsel; the Associate Director of Medical Affairs, Dr. Don Thomas; and the Inspection and Audit Unit, we now have new protocols that I would like the Board of Supervisors to officially review and codify. These new protocols provide us with the opportunity to review negative outcomes immediately, potentially save money because outcomes will be reviewed sooner rather than later, and wherever possible reduce settlement time frames.
Considering the enormous impact the newly established system has on the quality of patient care, reduction in negative outcomes and streamlining of corrective action plans, I MOVE THAT THE BOARD instruct the Director of Health Services and County Counsel to prepare appropriate documentation for the Board's review and approval which codifies the Department of Health Services' risk management protocol. This documentation should be presented to the Board within 30 days.
I FURTHER MOVE THAT THE BOARD instruct County Counsel and the CAO to coordinate efforts in the establishment and application of the Department of Health Services risk management protocols within all other County Departments and report back to the Board on their progress in 30 days.

MMA/jp