Tag Archives: dallas

Investigation finds hospital’s leader spent public money on personal interests

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Reese Dunklin and Sue Goetinck Ambrose of The Dallas Morning News document how Kern Wildenthal, the former UT Southwestern Medical Center president and its current chief fundraiser, spent hundreds of thousands in public dollars in recent years to build campus wine cellars, pay for his opera interests and travel to paradises around the world.

The investigation details a collapse in controls over taxpayer dollars and triggered a University of Texas System internal inquiry that found many of the same problems. Two auditors were jettisoned in response, Wildenthal will be forced to pay restitution and reforms are being considered. Continue reading

Dallas reporters use AHRQ data to measure patient safety

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Dallas Morning News continues its 19-month investigation into patient safety at UT Southwestern Medical Center and Parkland Memorial Hospital.

The project, “First, Do No Harm: An investigation of patient safety in Dallas hospitals,” is behind the website’s paywall but The Dallas Morning News has granted AHCJ members access. To find out how to access the stories, please click here and log in as an AHCJ member.

Among the latest reporting:

Dallas Morning News reporters Ryan McNeill and Daniel Lathrop took advantage of AHRQ’s Patient Safety Indicator (PSI) software, typically used internally by hospitals, to process 9 million publicly available patient records from Texas hospitals, all of which came from between

Parkland, the prominent local hospital that has earned scrutiny on numerous prior occasions, was just the most notable of a number of area hospitals that came up short (and generated headlines), but our interest lies more with the reporters’ investigative methodology as well as the path they’ve blazed for broader hospital quality reporting.

All their work was done in consultation with experts in the field, including academics, government officials and hospital administrators. An outside review indicated McNeill and Lathrop used the software properly, and their results were in line with a similar public analysis. But that’s not to say it was a simple process.

The newspaper spent six months analyzing nearly 9 million state hospital discharge records using Patient Safety Indicators, or PSI, software. This highly sophisticated system was designed for the federal government as a tool to measure potentially preventable complications among hospital patients.

The PSIs do not present a complete safety picture because they are based on administrative data — a summary of diagnoses, procedures and outcomes derived from patients’ medical charts, as opposed to a complete review of all medical records.

It’s not a perfect measure, but it’s one of the best available.

PSIs “reflect quality of care inside hospitals,” according to the Agency for Healthcare Research and Quality, a division of the U.S. Department of Health and Human Services. It released the PSI software in 2003 and periodically updates it, most recently in August. The News used that version for its final analysis.

The software analyzes the administrative data that nearly every hospital in Texas reports to the state. No patient-identifying information is included.

The results on 15 PSIs are statistically “risk-adjusted” because some hospitals treat a disproportionate share of unhealthy patients, who face a greater risk of potentially preventable complications. Rates from eight of the indicators are used to determine a hospital’s patient safety “composite score.”

The AHRQ has just started posting some PSI measures on Hospital Compare, and the Texas health department plans to follow suit in 2013, but reporters looking to get their hands on a broader swath of the data will still have to follow the Dallas duo’s do-it-yourself approach.

The reporters’ work drew criticism from the Texas Hospital Association, which said the methodology was “not intended for use in public reporting.” McNeill refutes its claims in a blog post. Daniel K. Podolsky, president of UT Southwestern Medical Center, also sent a letter criticizing the reporting. George Rodrigue, managing editor of The Dallas Morning News, published a point-by-point response to Podolsky’s letter.

Hospital sues to block release of records

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Parkland Memorial Hospital in Dallas, the subject of recent reports that patients were at risk, has sued the Texas attorney general in an attempt to prevent the release of records requested by The Dallas Morning News.

Brooks Egerton reports:

Parkland filed the latest lawsuit — its fifth against the AG related to the newspaper — on Monday. This time the goal is to block release of Parkland police department records dealing with the psychiatric emergency room. The News is not seeking medical records.

Related:

Reports detail Dallas hospital on brink of losing federal funds

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Late Friday, a damning federal report declaring that patients were at risk at Parkland Memorial Hospital in Dallas was released. Even later that same day, Dallas Morning News reporters Miles Moffeit, Sue Goetinck Ambrose, Reese Dunklin and Sherry Jacobsen published their first report online (available to subscribers only).

The reporters write that the inspectors’ findings were released in response to a reform plan the hospital submitted just before its Friday deadline, a plan they report “involves hiring new nurses; rewriting some policies; retraining staff; retiring outdated medicines, supplies and equipment; and launching an intensive series of daily or weekly performance audits over at least the next five months.” According to those who have viewed the 600-page release, they have a lot to overcome.

“It appears safety was routinely relegated to a lower priority by other pressures,” said Vanderbilt University professor Ranga Ramanujam, a national expert in health care safety. “The CMS action is extraordinary. I am hard-pressed to think of an example of a similarly high-profile hospital facing the very real possibility of losing their CMS funding as a result of safety violations.”

The paper’s speedy, thorough response to the release shouldn’t be entirely surprising, considering that they’ve been out ahead of the story from the very beginning.

The top-to-bottom July inspection of Parkland was sparked by a News report of the death of a Parkland psychiatric patient in February. The hospital didn’t report the death to the Texas Department of State Health Services or to CMS, both of which then investigated the case. CMS regulators later determined that the rights of the patient, George Cornell, had been violated repeatedly by Parkland.

The hospital has until Sept. 2 to get its correction plan approved by CMS and to pass inspections, otherwise it could lose the Medicare and Medicaid funds on which it so heavily depends.


Dallas Morning News hospital investigation required extensive use of public records

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

To understand the scope of The Dallas Morning News‘ “First, Do No Harm” series of investigations into publicly funded hospitals, take a look at the landing page. Spend a few minutes reading headlines (“Parkland CEO: ‘I did 17 amputations’ before getting medical degree” is my personal favorite), checking dates and clicking through to stories and you start to see the bigger picture. On its own, that page tells the tale of how reporters grabbed hold of a story and just wouldn’t let go.

That page ties together no fewer than 25 stories, 16 blog posts, 15 separate primary documents and three videos with a simple introductory paragraph:

UT Southwestern Medical Center and Parkland Memorial Hospital are known for their contributions to medical research and public health. But those accomplishments have come at a price. The Dallas Morning News investigates allegations of billing fraud, lax resident supervision, preferential medical treatment and patient harm at the publicly funded institutions.

Some of the material dates back to the paper’s 2007 investigation of a hospital giving special treatment to VIPs, but the vast majority of the work was done in 2010.

Of special interest to journalists: Maud Beelman, the deputy managing editor at The Dallas Morning News who leads a team of investigative and special projects reporters, wrote about the project for Nieman Watchdog. She details some of the struggles they faced to do the project, including getting public records, efforts to derail the investigation and the backlash from the hospitals.

Project looks at high price of health care in Dallas

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In their “The Cost of Care” package, Dallas Morning News reporters seek to explain why, as Jim Landers says in the lead of a key story, one of the nation’s largest cities is “broken market where doctors, hospitals and other providers shower patients with services of diminishing value but staggering cost.”

The problems are clear: The Dartmouth Atlas ranks Dallas as the 13th priciest health market in the nation, while new Census data gives Texans the dubious honor of living in the least-insured state in the nation. The whys and hows of these issues are trickier, but the Morning News wades into the health spending morass.

Dallas sees no relief in health care expenses as competition drives up costs

Jim Landers explores the paradox that health care in the city is expensive because there’s so much competition, and considers the contributions marketing and medical records make to health care costs. The piece includes an interesting profile of CIGNA regional president David Toomey’s attempts to rein in costs in the area.

‘Vicious circle’ of uninsured results in higher bills for health coverage, taxes in Dallas-Fort Worth

Robert Garrett and Jason Roberson explain how everybody pays the price for the area’s super-low insurance coverage rates, and put an exact cost estimate, both financial and human, on the price of a high uninsured population.

Doctor-owned hospitals a lucrative practice, though opinions split on benefits

Gary Jacobson’s weighs the costs and benefits, both economic and medical, of doctor-owned hospitals, which are more common in Dallas than any other major metropolitan area.

Medical imaging a growth industry, but some say unneeded scans increase expenses

Ryan McNeill assesses just how useful the high-speed, unregulated growth of medical imaging has been for patients, doctors, investors and other stakeholders.

Critics see home health care boom as wasteful, but others tout benefits

When you’re looking to explain growing costs, it makes sense to focus your efforts on growing sectors, and Gregg Jones does just that, looking at the fast-growing home health sector. He leads with Medicare fraud, but then shows just how much deeper and more complicated the cost equation of home health care can get.