(Story update on January 20, 2017)
The Indian Health Service is seeking a new quality chief to implement remediation programs at agency facilities, many of which it admits are delivering poor quality care to the nation's native American population.
The new position will implement a program developed over the past several months after Senators John Barasso (R-Wyoming) and Jon Tester (D-Montana) sought a Government Accountability Report evaluating the quality of care at agency hospitals, especially across the Great Plains states.
The GAO report, released Monday, found several IHS facilities provided limited and inconsistent quality reports to their government boards and agency headquarters and failed to report many adverse events. The government auditors also documented the massive leadership turnover at many facilities.http://edit.modernhealthcare.com/apps/pbcsedit.dll/red
A Modern Healthcare report last month documented a series of deaths and incidents at a small IHS hospital in Winnebago, Neb., which led to the facility being cut off from Centers for Medicare and Medicaid funding. The facility has had 10 CEOs, eight of them acting, in the past five years.
In response to the Congressional scrutiny, the agency in recent months has signed a one-year $700,000 contract with the Joint Commission Resources to provide technical assistance, education services and training to help IHS' 26 hospitals and 56 health clinics centers in the Great Plains Area comply with CMS standards. The 19 hospitals and 287 clinics independently operated by Indian tribes weren't evaluated by the GAO.
In a response to the GAO, Jim Esquea, the assistant secretary for legislation at the Health and Human Services department, said the agency was taking a number of steps to improve quality at IHS beyond developing new standards and hiring a new quality chief. It recently contracted with HealthInsight, a federally-qualified quality improvement organization to “redesign, if needed, the IHS hospital operating infrastructure … focus(ing) on leadership, staff development, data acquisition and analytics, clinical standards of care, and quality of care.”
The agency last month also began implementing a “just culture” program to encourage employees to speak out about poor quality care at facilities. The goal is to create “an environment in which staff are encouraged to report errors and other safety events without fear of retribution or retaliation and where data are used to drive improvement,” Esquea wrote in response to the GAO report.
The agency also pledged to track the remediation efforts.
Correction, January 20, 2017:
This story was updated to properly describe the scope of the Joint Commission's contract with IHS. An earlier version of this story incorrectly stated how the Joint Commission Resources would help the agency's facilities.
