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Findings and Recommendations 5 findings
F1
Morale Continues to Deteriorate
Related Recommendations (1)
R1
That the Department of Health Services (HS) management ensures that the Recommendation Teams’ action plans for change are clear, concise, actionable, and measurable in order that the 6-month post-implementation evaluation survey will be effective. 5/9 June 15, 2004
F2
Security and Workplace Upgrades Remain Incomplete
Related Recommendations (1)
R2
That HS management adjusts the evaluation survey date so as to ensure that quantified outcomes of the consultations’ effectiveness are in the hands of the grand jury by January of 2005. As the action plans developed by the Recommendation Teams are expected to be implemented in June 2004, more than a 6-month period is available to complete the assessment and meet this deadline. The plan for conducting the post-process survey should be forwarded to the 2004-05 grand jury.
F3
Complaints Related to Management Rise to New Levels
Related Recommendations (1)
R3
That HS management creates a brief rating scale to assess results of the consultation and to establish a baseline for measuring changes in staff-management relationships in the future. The survey form with its questions and numerical measurement model should be forwarded to the grand jury.
F4
Incomplete Consultant Assessment Precludes Evaluation of Effectiveness
Related Recommendations (1)
R4
That HS management creates written performance standards and expectations for MHS senior management aligned with the goal of improving skills in relating with staff as identified by this report and the consultation process; include these standards in the annual performance evaluation of both senior and line staff management effectiveness.
F5
Patient Care Potentially at Risk
Related Recommendations (1)
R5
In conjunction with staff, that the Mental Health Services Division (MHS) management establishes methods for acknowledging the specific and individual contributions of department members on an ongoing basis.
Additional Recommendations 5
These recommendations are not explicitly linked to specific findings.
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R6That MHS management clarifies with staff and put in writing the proper procedures for reporting various levels of safety concerns, being sure the forms, when required, are available.
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R7That HS management creates a form and provides staff with a process to report in writing to the safety committee, situations and conditions they consider unsafe or to document incidents in which their safety was jeopardized. A timely feed-back mechanism to advise a submitter in writing of the disposition of the report should be devised.
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R8That HS management provides all staff with instruction and information regarding anti- retaliation laws--federal, state, civil service or labor --- and the agencies and services provided to assist them if retaliation is perceived or feared from supervisors for any work- related reasons.
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R9That HS management affirms and delineate appropriate boundaries between medical and managerial authority in PES based upon The Medical Board of California’s Corporate Practice of Medicine Guidelines and the California State Business and Professions Code, Sections 2050-2079, Section 2190-2196.5, and Section 2400-2417.
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R10In view of the prolonged character of problems in MHS and in view of MHS medical staff bringing these issues to the Board’s attention at their meeting on March 23, 2004, the Board of Supervisors should report to the grand jury what requirements they will establish to ensure that HS management addresses grand jury recommendations. Required Responses to Findings Board of Supervisors
Conclusions 1
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CL1 Page 5The grand jury commends the many dedicated and skilled individuals who are providing mental health services for Sonoma County in an often difficult environment. It is recognized that changes over the past several years have been implemented to provide more effective mental health services such as movement to the team Assertive Community Treatment (ACT) approach. While MHS and HS senior management have attributed staff discontent to a highly vocal core of continually disgruntled employees who are resistant to change, the consultant’s assessment and further investigation by this jury indicates that a significant management/staff relationship problem can no longer be denied. Worker concerns of safety, training and facility maintenance and improvement do not appear to have yet overcome structural and bureaucratic hurdles, even with some items that should have been easy to do. Because of the slow pace of addressing improvements over the last several years, it is not surprising that staff morale and hopes for the future are so low. The grand jury, rather than their own management, is seen by many as the primary impetus for recognizing and solving problems. When over 20% of the staff, a large number of interviewees and nearly all of the physicians at MHS, indicate that the management/staff relationship is a major problem, MHS and HS management should take notice. Whatever the cause of the discontent, when it reaches such a significant level and is increasing, it should be addressed and steps taken to correct management style and return to a balance so that patient care is not put at risk. With budget contractions likely to impact mental health services, and the medical staff having exposed their discontent directly to the Board of Supervisors, these conflict issues must be addressed. Sonoma County mental health services has enough problems and should not be further burdened with management/staff conflicts. Because of MHS’ history of slow recognition and implementation, and the opportunity for significant improvements that are possible from the assessment project’s team recommendations, there will be a need for a future grand jury to follow the progress.
No Responses Found 1
Government entities assigned to respond to this report. No response documents have been linked in our database.
Sonoma County Board of Supervisors
Elected County Office