The California Department of Health Services has concluded that three Kaiser Foundation hospitals allowed unlicensed operating room assistants to perform tasks they weren't licensed for.
The initial complaints were brought by the California Nurses Association, which has long alleged that Kaiser is cutting corners on patient care to save money. The nurses union says Kaiser allows lower-skilled, unlicensed personnel to care for patients in ways that are beyond their ability and training.
Kaiser said it was out of compliance with its own policies in at least one of the hospitals and would make efforts to clarify its policies and enforce them better.
The CNA represents about 7,500 Kaiser nurses. The union is continuing to call attention to what it regards as Kaiser's ongoing failings despite settling its long-running contract dispute in April.
In this instance, state inspectors substantiated the CNA's complaints in three separate investigations in May, June and July:
At a Kaiser hospital in Santa Rosa, an orthopedic assistant who worked for the Permanente Medical Group cauterized tissue, sutured wounds, drilled bone, pounded pins in knee replacements and placed a retractor in a hip wound. The orthopedic assistant did not have the training necessary to do these tasks, which are reserved for physicians under state law.
At Santa Teresa Community Hospital in San Jose, an unlicensed orthopedic technician sutured tissue and injected local anesthetics into patients.
At Kaiser Foundation Hospital North in Sacramento, unlicensed orthopedic assistants cut and tied sutures, and applied clamps.
Robert Klein, M.D., associate executive director in charge of operations at the Permanente Medical Group in California, said that in the Santa Rosa instance, "we were out of compliance with our own policy. That is totally unacceptable. We need to adhere to our own policy."
He said the other two cases were not as egregious and had primarily to do with missing documentation. He will shortly issue a memo underlining Kaiser's policies on surgical assistants. Each assistant and each surgeon will have to sign a document indicating they understand the limits of their scope of practice and will comply with it.