A key unit at Santa Barbara Cottage Hospital has been restricted from accepting new sufferers underneath a California program for chronically unwell kids till it addresses dozens of considerations raised by state regulators.
The California Division of Well being Care Providers discovered that the pediatric intensive care unit at Santa Barbara Cottage Hospital had fallen in need of requirements for the California Kids’s Providers program, which serves younger individuals as much as age 21 with persistent situations comparable to most cancers, coronary heart illness, cerebral palsy, traumatic accidents and hemophilia — a bunch that the company known as “our youngest and most weak Californians.”
Amongst its findings and proposals: The pediatric intensive care unit wanted extra staffing with important care physicians. State reviewers wrote that at its stage of staffing, notably with the medical director needing to tackle administrative duties, “this isn’t a secure working setting for the physicians and thus not a secure affected person care setting.”
Essential care physicians advised the state company there have been instances once they wished to move a affected person elsewhere for care — together with some whose situation “portended decline that will unnecessarily endanger the affected person if not transported” — however have been prevented from doing so or confronted “disciplinary actions” for it, based on a state report on the findings.
Amongst “essentially the most egregious findings” have been considerations in regards to the pediatric intensive care unit working outdoors of this system requirements; insufficient insurance policies and procedures; and failures to debate issues in an organized method and act on findings to stop future points, the division mentioned in a press release to The Instances.
The Division of Well being Care Providers mentioned the Santa Barbara hospital had submitted a plan to handle such considerations in late July, the main points of which the company continues to be reviewing.
New admissions to the pediatric intensive care unit for sufferers enrolled within the California Kids’s Providers program — typically abbreviated as CCS — will proceed to be restricted “till the division has assurances that the corrective actions will tackle deficiencies, particularly these which are most egregious and require instant motion.”
Hospital officers mentioned they have been working to implement the state suggestions in order that they will get its approval to reopen the unit to new sufferers within the CCS program, who normally make up roughly a fifth of sufferers in its pediatric intensive care unit.
Within the meantime, the unit is constant to take care of younger sufferers who should not within the CCS program. “We’re assured that these findings and the suggestions are simply going to make us stronger,” Cottage Well being vice chairman of affected person care providers and chief nursing officer Laura Canfield mentioned.
Santa Barbara Cottage Hospital officers additionally defended their efficiency and disputed a few of the particular findings within the report. As an example, when requested about physicians being prevented from transferring sufferers to different amenities for care, Canfield mentioned, “We don’t have any knowledge that helps that narrative in any respect.” In response to staffing considerations, officers mentioned the unit has been staffed across the clock by important care physicians.
The state evaluation additionally indicated that there was no pediatric neurosurgeon who met CCS program necessities on employees. Dr. Miriam Parsa, chief pediatric medical officer on the hospital, mentioned it had a neurosurgeon who did meet the necessities, as a result of the physician had “proficiency within the care of pediatric sufferers.”
The DHCS mentioned it decided that it wanted extra data to evaluate whether or not that doctor meets the requirements of this system. “A pediatric neurosurgeon will need to have the suitable coaching, board certification, and expertise to supply care to pediatric sufferers,” it mentioned in an e mail.
The Santa Barbara hospital is the second facility the place the state has taken such motion this yr: Earlier this yr, John Muir Medical Middle in Walnut Creek was restricted from admitting new CCS sufferers to its pediatric intensive care unit till mid-August, when the restrictions have been lifted. The state transfer adopted a string of investigations by the San Francisco Chronicle into affected person deaths on the Walnut Creek facility.
Cottage Well being public relations supervisor Cristina Cortez mentioned the pediatric intensive care unit on the Santa Barbara hospital “gives distinctive high quality care, with zero affected person hurt occasions [since January 2022] and ninetieth percentile affected person satisfaction rankings for the previous 5 quarters.” Canfield mentioned the DHCS findings weren’t primarily based on affected person outcomes, and “our outcomes are actually, actually good.”
Limiting admissions to the unit “has been a horrible hardship for our sufferers and our households,” who’ve needed to journey outdoors of Santa Barbara County and miss work to get the care their kids want, mentioned Parsa, who can also be a pediatric rheumatologist.
“If we didn’t suppose this program was robust and capable of present the providers that we all know we are able to present — and we’re offering — we wouldn’t have a PICU right here,” Parsa mentioned.
