Union boss: Cost cuts to blame for dirty DMC tools

Joel Kurth
The Detroit News

A union leader representing Detroit Medical Center workers has issued a report blaming cost-cutting for a decade of problems with dirty surgical instruments at the hospital’s Midtown campus and proposing a series of investments to fix them.

In the past few days, a report from an American Federation of State, County and Municipal Employees local chair was sent to the system’s Children’s Hospital of Michigan unionized workers. It addressed The Detroit News investigation into 11 years of complaints about dirty, broken and missing tools at the hospital system that was acquired in 2013 by the for-profit Tenet Healthcare of Dallas, Texas.

“The TRUTH is that both ... workers and their unions have been begging management to address these issues FOR YEARS,” read the report from Donna Stern, unit chair of AFSCME Local 140 that represents 250 Children’s workers including a quarter of the Midtown campus’ 70 sterilization technicians.

“The cause of these problems are no great mystery,” the report continued. “Quality healthcare cannot be provided when shareholder profits are the real priority.”

The report recommends six solutions, including hiring more staff and implementing quality controls, that Stern said DMC leaders have rejected over the years.

It comes as regulators from the state Department of Licensing and Regulatory Affairs and federal Centers for Medicare and Medicaid Services are amid an investigation into the DMC. It focuses on The News’ revelations that improperly sterilized tools complicated operations from brain surgeries to spinal fusions, kept patients under anesthesia unnecessarily and led to cancellations of dozens of operations.

The News series was based on 200 pages of emails and internal reports from doctors and administrators complaining the issue put patients at risk, an assertion the DMC denies. The system has said no infections were caused by dirty instruments, which its quality control system prevented from reaching patients.

“DMC management, our union representatives and our employees are working together to ensure that we are delivering high quality care to patients and making sure our hospitals run as efficiently as possible,” the DMC said in a statement Monday.

The DMC has said the problem stems from a Central Sterile Processing Department. Located in the basement of Detroit Receiving Hospital, its workers clean, sort and package thousands of instruments per day into sets for surgery at Receiving, Children’s, Harper University, Hutzel Women’s and DMC Heart hospitals.

Stern leads one of four locals that represents DMC sterilization departments. Another two AFSCME locals along with the Service Employees International Union represent unionized DMC employees.

Stern told The News her report represents her views and not necessarily those of AFSCME Council 25. Its president, Al Garrett, did not return messages for comment. Nor did Marge Robinson, president of the SEIU Healthcare Michigan. The News on Monday could not reach the chairs of AFSCME’s other locals — No. 181, representing workers at Receiving, and No. 3695, representing Hutzel workers.

Stern told The News that unions have pleaded for years for better training and more workers. Among other cuts, she said the DMC eliminated a system to double-check instrument sets for cleanliness and refused requests to purchase more instruments to ease the “quick turnaround” of cleaning that can lead to mistakes.

“Certainly, the unions have taken the position that the staffs shouldn’t be cut and put forth solutions. They were basically ignored,” Stern said.

“A lot of workers have been complaining about conditions for a long time. They were always told there wasn’t money to fix those things.”

She described a department where high stress and burnout from “extremely hard labor” lead to frequent turnover. Stern said the problems began when former DMC CEO Mike Duggan, who is now Detroit’s mayor, merged sterilization departments at Receiving, Harper and Children’s into one “enormous department.” Duggan resigned in 2012 to campaign for mayor.

Surgical tools are different for children’s hospitals and trauma centers, and the consolidation meant sterile technicians could no longer specialize in instruments for one operating room, Stern said. The DMC eliminated a position that continually retrained workers on cleaning new equipment, Stern said.

“Cost-cutting is what brought us to this point,” the report read. “Rebuilding the DMC’s reputation will require more than verbal assurances, window dressing or more ‘efficiencies’ and will certainly not be achieved by blaming, scapegoating or threatening CSP workers in any way.”

Duggan on Monday said many major hospitals consolidate sterilization departments to increase efficiency.

“When done well, they provide a single standard for processing instruments under unified supervision, instead of trying to manage multiple staffs at multiple sites with multiple supervisors and multiple processes,” he wrote in a message to The News.

Duggan called criticism that he was trying to save money “revisionist history.” He said AFSCME “very strongly and publicly supported” the DMC’s 2010 sale to the for-profit Vanguard Health Systems, a Nashville, Tennessee, network of hospitals that Tenet acquired in 2013.

The report stands in contrast to internal emails from surgeons and former sterilization managers who contended unions are so powerful that discipline was overturned — or never pursued — for employees who improperly cleaned equipment.

“When we have issues regarding soiled trays, which can cause the death of a patient, it should not be taken lightly. No matter how many threats of arbitration are made,” one of the managers, Lukeysih Hall, wrote in a March 2, 2015, email.

Stern is calling for an end to consolidated sterilization departments, more staffers, raises from the $18 per hour paid to most sterilization workers, more equipment and reinstatement of quality systems she said were phased out.

DMC in June hired a private company, Unity HealthTrust of Birmingham, Alabama, to manage the sterilization department. Stern said she’s seen some improvement and credited the company with reinstating an on-site education trainer.

“There’s a spotlight being shown on it and more attention is being paid to (the problem),” Stern said. “Whether there are permanent solutions remains to be seen.”


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