Patient Services

By Suzanna Coxhead

• Mental Health. The County is responsible for Marin's mental health services not Marin General Hospital. Marin General maintains a 15 bed behavioral health inpatient unit for private and for County patients, including medi-cal patients. However, County patients regularly go out of county for care for several reasons, one, because there are no open beds; two, because the County can get care at lower cost else where and three, because the patient presents a specific problem which can be better cared for in a different type of environment than the Marin General unit provides. The mental health wing of the Hospital also includes a second unit which is operated by the County for patients on 23 hour holds, but which has also been used by the County for office space. The Hospital and the County have been in discussion for months to move the office personnel and to make some of that space available for additional long term inpatient mental health beds. The Grand Jury completed a report on mental health services in the Summer which was critical of both the County and the Hospital for not working together more constructively to develop a plan to expand the number of acute care psychiatric inpatient beds at the Hospital. I support the County and the Hospital developing a more cooperative working relationship and if re-elected, I will encourage the District to put pressure on both entities to follow through.

•Staffing: Because of the higher acuity levels of patients and because of the State's new nurse/patient ratios, Marin General has focused on hiring more nurses, which I support, and now has more nurses than at any time since at least
1993. There is a well publicized nurse shortage throughout the country. Marin General has been more successful than most hospitals in recruiting nurses with competitive salaries and benefits and by working with other Sutter hospitals in developing a comprehensive recruitment plan which includes working closely with Bay Area nursing schools. While other candidates allege that our hospital is understaffed, I do not support that premise. At any one time, there can be staffing shortages in a department because of staff turn over and because of the severe shortage of technically trained personnel in many health fields, not just nursing. It is not the job of the District Directors to micro manage the Hospital's operations and staffing. Rather, as a District Director, I support working with the Hospital and other community organizations to help solve such challenging problems. The District Board, for example, could reestablish its grant making program and make a grant to the College of Marin nursing program specifically to hire a nurse educator as another Healthcare District has done. This year, the District will receive approximately $405,000 cash (rent and settlement) from Marin General which will allow for grant making, if District expenses are carefully managed.

• Quality of Care: Marin General is a good hospital with excellent doctors and nurses. Last year, Marin General received a 96 rating by JCAHO, (Joint Commission on the Accreditation of Healthcare Organizations), one of the highest scores in the country and the highest rating of all Sutter Health hospitals surveyed last year. JCAHO is the most well known accreditation organization nationwide and surveys each hospital every three years. In addition, there are patient satisfaction surveys of hospital patients and quality of care surveys of medical outcomes. Many of these indices are still in their formative stages of development and positive or negative results can be misused. I do believe that it is the role of the District Board to monitor quality of care indicators and patient satisfaction surveys and to raise accountability questions if ratings are consistently lower than for comparable hospitals.