Wednesday, October 24, 2007

Grady Roundup

Since the strange tale of Dr. James Murtagh, the fires of the Grady crisis have somewhat cooled. It is as if the city, region and state took a collective deep breath before the struggle which is sure to commence in January.

This does not mean activity has not been floating around just under the public's radar. Here are some items of interest.

Sen. David Shafer (R-Duluth), who has played a critical role in tempering the rift between state and local, takes the AJC to task for two recent editorials criticizing State officials who are asking for accountability before providing funding.

But it is ridiculous for him to suggest that contract and culture reform are “sideshows” to Grady’s “revivial.” They are central to saving the hospital. Just like you cannot fix a leaky bucket by refilling it with water, you cannot save Grady with money alone. It takes governance, contract and culture reform, and those cannot “wait.”
Sen. Shafer also provides an explanation of DSH or "DiSH" and how it is possibly hindering Grady.

Yes, Grady has been hurt by the redirection of DSH funds. But as I told James Salzer of the AJC, Grady’s problems are bigger than this one program, and those problems cannot be solved with money alone. Saving Grady will require a combination of governance, contract and culture reform, and all three must be vigorously pursued.
Meanwhile, one of the current participants in Grady funding Dekalb County has its own politician wading into the fray. Republican commissioner Elaine Boyer has presented a rather strongly worded resolution regarding the relationship between Grady and the largest employer in Dekalb County, Emory Hospital.

1. Emory would forebear inadequately documented bills, eliminating debt from Grady’s balance sheet and giving the troubled hospital much needed breathing room.

2. Grady and Emory would implement audit recommendations requiring full documentation of all future bills. Grady’s auditors say that new documentation procedures would not only help Grady financially but improve the quality of patient care. Full documentation would also end the discriminatory treatment of Morehouse which is inexplicably required to provide six times as much documentaion for its doctors than Emory.

3. Emory would assume liability for its own malpractice. Not only would this save Grady millions of dollars each year defending and settling lawsuits against Emory employees, it would bring the Emory-Grady contract in line with best practices and likely improve the quality
of patient care.

4. A new Emory-Grady contract would be negotiated recognizing Grady’s in-kind value to Emory as both a tool to attract tuition-paying students and a source of patient and research revenue.

Positions are being taken. Maneuvering is being done. All agree the a solution has to be met. The only questions remaining are will the chicken (funding) or the egg (reform) come first and of course, the all important, who will get the credit. Stay tuned.


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