CASE #1399:  San Joaquin County General Hospital





A complaint was received asking the Grand Jury to investigate the management practices in the Clinical Laboratory at the San Joaquin County General Hospital, as outlined by the unsigned letter and a majority of the Laboratory employees involved.





The complaint addresses issues of mass exodus of employees and low morale in the Clinical Laboratory.  The Hospital last year hired the consulting firm of George Simmons International.  The Firm was requested to interview the employees and managers of the Laboratory, present an assessment of the current operation environment and provide recommendations for re-establishing teamwork and positive working relationships with the Department.  Hospital Management is now implementing these recommendations.





The Human Services Committee met with Hospital Management on January 20, 2000, to discuss the current problems and to see if the Hospital is aggressively pursuing solutions to improving services and confidence with physicians, patients and others.  We were informed that team building activities and Laboratory quality improvement projects, under the direction and supervision of a qualified person in this field, have been implemented and are showing positive results in the Laboratory toward improving communication and relationships among employees and management.  On February 15, 2000, we requested additional reports on the last Clinical Laboratory Improvement Amendment (CLIA) survey report and also the latest Joint Commission on Accreditation of Hospital Organizations (JCAHO) survey report, to better understand and evaluate the problems in this department.  The committee has also requested copies of the Laboratory Quality Improvement working group meetings and the Laboratory Leadership group meetings.  These reports have been received and reviewed by the Grand Jury.






We received copies of all the recent Laboratory Quality Improvement working groups meetings along with copies of all the Laboratory Leadership group meetings.  It is apparent from the meetings that they are trying to reconstruct the Laboratory Department to accomplish the following:


·        Improve Supervision

·        Increase Professionalism


The Grand Jury believes that Management is doing a good job rebuilding this Department.  However, this is just the beginning and it is apparent that it will take at least a year to complete this rebuilding process.


This problem has been going on for almost two years.  From information that we received, it was apparent that everyone knew the problem existed, including Laboratory Employees, Laboratory Managers, Executive Management and Supervisors.  The Grand Jury cannot comprehend why it took so long to recognize the seriousness of these problems.





Better communication between Laboratory Management and Department Employees.  Initiate a program of trust and credibility between Management and Employees.  Encourage SEIU representatives to engage in dialogue with not only Department Employees and Department Managers, but also with the Hospital Director and the Director of Health Care Services.  Laboratory Managers and Supervisors should take advantage of all resources available, such as the County’s New Managers course or the Management Certificate Course offered at the University of the Pacific.


The Grand Jury strongly recommends that the 2000-2001 Grand Jury initiate a follow up program with the Hospital Director to monitor the progress of the current rebuilding programs in progress until its completion.