Parkland Memorial Hospital is one of the largest public hospitals in the nation and the safety net for thousands of poor and minority patients in North Texas. But a multiyear investigation by The Dallas Morning News revealed systemic patient harm and prompted a federal crackdown that threatened to close Parkland. The last step in our investigation, 2013’s “Chronic Condition,” exposed problems that persisted despite round-the-clock government monitoring. This required long-term battles for public records, cultivation of sources among patients and hospital workers, and analysis of decades of financial data. The resulting five-part series showed how patient safety often came last at Parkland.
Among the findings:
* Parkland put image before patients. When egivers of sexual abuse, Parkland’s in-house police force claimed exclusive jurisdiction. Officers made no arrests in 25 cases we identified. One nurse aide was simply ticketed and fined. One police officer, meanwhile, kept his job despite exposing himself to a girl in his home. We also found that Parkland and its academic physician affiliate, the University of Texas Southwestern Medical Center, were slow to punish alleged offenders, if at all. Some patients and staff involved in the cases alleged cover-ups, and indeed Parkland made our work difficult. Officials wouldn’t talk and sued the Texas attorney general in an effort to block the release of hospital records. Parkland’s PR crisis managers issued thinly veiled threats about potential consequences if our reporters continued visiting the public hospital without official permission.
* Parkland put its partner before patients. Parkland and UT Southwestern’s divergent missions, business interests and turf battles created an unhealthy culture. Hospital managers relinquished control of clinical operations to UTSW. But the school wanted faculty doctors to focus on teaching, research or treating privately insured patients at its own hospitals. Records and interviews showed that faculty physicians repeatedly failed to show up and supervise resident trainees, leaving them alone to practice on Parkland’s patients. All the while, UTSW sought higher pay for its services from the taxpayer-financed hospital. Parkland acquiesced time and again, frustrating the rank-and-file who wanted UTSW doctors held accountable for patient care.
* Parkland put expansion before patients. The conventional wisdom in Dallas and at the Legislature was that Parkland was starved for cash. Yet starting in 2004, hospital management began amassing more than $1 billion for a state-of-the-art new facility, our data analysis showed. Parkland reduced the number of nurses and available beds. It moved surpluses out of operating budgets, which were made flush with one of Texas’ most generous hospital-tax subsidies. It also let its existing campus fall further into disrepair. As conditions deteriorated, safety inspections increased. Parkland has since been forced by monitors to plow more than $75 million back into patient care.