Maricopa County's public health system has regained accreditation from a national agency that inspects medical facilities, fixing record-keeping and other problems that could have threatened its federal funding.
The Joint Commission announced Tuesday that it awarded Maricopa Integrated Health System full accreditation following a daylong surprise inspection Monday.
"Now that we've passed, we can feel much better about what we believe is the true quality of care that's being provided," said Bil Bruno, chairman of the health system's board.
Bruno, who's been on the board since voters created it, said members agreed to continue paying for the Joint Commission reviews to get precisely the kind of feedback the agency provides.
"We weren't thrilled about them finding deficiencies in various areas," Bruno said. "But that's why we pay them, to come out and check us out."
The safety-net hospital system, which includes 11 clinics, two psychiatric centers and a nationally known burn unit, primarily services the Valley's poor and uninsured. The centerpiece is the 450-bed Maricopa Medical Center in Phoenix.
After a five-day visit in September 2007, the commission gave the hospital system a "preliminary denial of accreditation." That was upgraded to conditional accreditation following appeals that showed that some of the deficiencies already had been fixed.
Among the 16 problems that remained, surveyors found chronic record-keeping issues and deficiencies in the hospital's psychiatric unit and its Desert Vista Behavioral Health Center in Mesa. Tracking patient records, inspectors found that some psychiatric patients were restrained and secluded without ever being told why, in violation of commission standards. Others were restrained without orders from above.
Betsey Bayless, CEO of the health system, said adding personnel, retraining and systemic changes helped turn things around.
"We've come a long way and I'm very proud of our effort," Bayless said. "We have put in place a much-enhanced quality-assurance team."
Beyond that, Bayless said, the system's 4,000-plus employees have been "empowered" to report problems they see.
The system has begun the first phase of an electronic medical records system that will prevent many of the problems found in the audit, she said.
Voters approved the health care district in a special election in 2003 and created a property tax hike to help fund it and a nonpartisan board to run it.
The first board was elected in 2004 and four new board members were elected in November, including former state Department of Health Services director Susan Gerard.
Department staff provided technical assistance to the health system during the past year, she said, and the resulting changes are more than "just filling in the cracks."
"There was never any question in my mind" that the system would regain accreditation, Gerard said. "Those folks over there took it very seriously."