San Francisco County Grand Jury
• 1999-2000
Summary Members of the Civil Grand Jury (cgj) investigated various problems at San Francisco General Hospital (sfgh),
⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Recommendations 9
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R1Instead of closing or privatizing the pharmacy, SFGH should open a second pharmacy. SFGH should also replicate, wherever feasible, Kaiser Permanente’s efficiency measures in dispensing prescriptions. The goal is to minimize the excessively long waiting time for prescriptions. Required Response Department of Public Health Health Commission
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R2DPH should approach major software producers for their expertise and assistance in upgrading its computer system since a highly efficient and sophisticated computer system, like Kaiser's and that of many neighborhood pharmacies, would make dispensing medication more efficient. Required Response Department of Public Health Health Commission
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R3Fill the staffing vacancies in the clinics to cut the long delays in getting an appointment. A reasonable goal would be to set an appointment within seven to fifteen days after a patient makes a request by telephone or consults a doctor. Required Response Department of Public Health Health Commission
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R4Ensure that neighborhood health centers function at full staffing levels since they provide critical preventive care and language assistance in the neighborhoods that they serve. Required Response Department of Public Health Health Commission
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R5Provide urgent clinical care and extend the hours to eliminate or minimize the need for patients requiring non-acute care to seek treatment in the emergency room. Doing so would provide some relief to overextended emergency room staff and would decrease the need to divert patients who need critical and immediate emergency care to other hospitals. Required Response Department of Public Health Health Commission
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R6Continue providing the current level of in-house psychiatric care to the mentally ill since the strong family involvement program, the specialized and culturally sensitive care to a diverse population, and the multilingual capabilities to help the limited-English speaking and monolingual patients have all contributed significantly to the quality of the care. Required Response Department of Public Health Health Commission
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R7Develop a comprehensive citywide plan to ensure that the residents of San Francisco have access to essential emergency room services during normal circumstances and during crises arising from earthquakes, other natural disasters, terrorist attacks, or any other emergency, and present that comprehensive plan to the Health Commission. Required Response Board of Supervisors Department of Public Health Health Commission Office of Emergency Services
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R8Take the necessary procedural steps to separate administratively and actually the budget of SFGH and clinics from the budget of DPH to ensure that funding to provide essential medical care is not diverted to other well-intentioned programs and services that address broader societal concerns but are peripheral to the health care that SFGH has provided in the past and should continue to provide to the people of San Francisco. Required Response Mayor Board of Supervisors Department of Public Health Health Commission
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R9Based on the perception of the CGJ that there is a critical lack of long-range planning in DPH; DPH should comply with the City Charter requirement that all departments have a functional three-year plan, thus enabling DPH to make realistic budget projections rather than reacting precipitously to recurring deficits. DPH should formulate this plan after there is sufficient input, via public forums, from all affected parties. Required Response Board of Supervisors Department of Public Health Health Commission
Conclusions 1
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CL1The CGJ focused its review on the SFGH pharmacy issue because of an ongoing problem of patients waiting three to five hours or days for a prescription. This problem has lasted 10 years. From our interviews with pharmacists and other health care professionals at hospitals and neighborhood pharmacies, we learned that, given the ratio of pharmacists and support staff to the number of prescriptions filled, the workload does not warrant waiting for up to five hours for prescriptions. The time taken to fill prescriptions at other hospitals and neighborhood pharmacies throughout the city generally takes 10 to 30 minutes. Kaiser Permanente has been able to lower costs by ordering drugs in large quantities enabling prescriptions to be packaged in quantities of 30, 50, or 100. At their new facility in San Francisco, Kaiser has established smaller pharmacies on every floor, and reports that has increased efficiency. CGJ members share the concerns expressed by neighborhood pharmacists, community activists and other health care workers that closing or privatizing the pharmacy would result in further deterioration in service. The long waiting time for clinic appointments is unacceptable but is not a "high priority" item for DPH. According to DPH administration, there are more critical needs for budget dollars. The department's hiring freeze has led to insufficient staff in the urgent care clinic, excessive overtime costs and increased diversion of people requiring emergency room treatment to other hospitals. The lack of staff has also delayed responses to telephone calls from people seeking information or appointments. Instead of determining how DPH can provide essential services, DPH administration appears to be more concerned with making cuts.