Friday, June 25, 2010

Parkland Hospital board meeting shifted to closed session

Should Parkland Hospital be allowed to have a board meeting that is closed to the public?  J-D says, "No Way!"

SHERRY JACOBSON and MILES MOFFEIT of the Dallas Morning News says, Hundreds of babies delivered prematurely at Parkland Memorial Hospital may be at risk because they are not being kept warm enough immediately after birth, according to a study presented to the hospital's board of managers on Tuesday.

The study included recommendations on how preemies delivered by Caesarean section can be kept warmer in the operating room. But it's unclear what the hospital board decided to do because its members abruptly decided to meet behind closed doors.

Parkland officials defended the decision but gave conflicting reasons why the private discussions were necessary.

Dalton Lott, chairman of the board's quality and risk management committee, said the unannounced executive session included a discussion about personnel. The public agenda listed no such discussion.

Parkland board chairman Dr. Lauren McDonald said the closed session centered on the hospital's care for HIV patients.

"We don't have to be going over our reasons for this," Michael Silhol, Parkland's general counsel, told two Dallas Morning News reporters asked to leave the meeting. "We have the right to do it."

Silhol said that Section 161 of the Texas Health and Safety Code allowed the Parkland board to meet in closed session without advance public notice.

But attorney Joseph Larsen, an expert on the Texas Open Meetings Act who represents The News, said Parkland's move appeared to violate open government requirements. The state Health and Safety Code, Larsen said, permits an exception to the open meetings law only to allow a hospital board to receive information in private. Board members may not otherwise deliberate, he said. Silhol had no further comment.

The Parkland board does not typically hold executive sessions as part of its committee discussions unless scheduled. "The attorney general has specifically disapproved of agendas that are misleading," Larsen said.

McDonald explained that she was concerned about allowing reporters to hear board members' comments. "We had a casual discussion at the last board meeting, and you ran out and published it online," she said. "We want to be careful. We want you guys to get actual information."

According to the board's public agenda, its quality and risk management committee was to review a study showing that 56 percent of premature babies delivered by C-section at Parkland were "too cold."

Parkland met state standards for birth temperatures for premature infants but failed to meet World Health Organization requirements. "Hypothermia at birth is associated with increased risks for sepsis [infection] and death," said a summary of the report, attached to the agenda.

Warmer temperatures increased the success of resuscitating newborns, the report said. It didn't specify how many premature babies were in the study or whether any suffered complications. Parkland handles about 16,000 births annually, only about 5 percent of which are premature.

To improve conditions, more than $8 million in possible upgrades to climate control, new equipment and building renovations were outlined in the report to the board.

The board also received an overview of Parkland's HIV services, indicating that the number of patients was up 2 percent in 2009 to 5,629. Parkland has been reorganizing its approach to treating HIV/AIDS patients.

When questioned later about the decision to close the meeting, Silhol objected to the presence of two News reporters. "Why were you here?" he demanded of one attending for the first time. "You are not normally [here]."

The board spent nearly half of its normally daylong public meeting behind closed doors.

It reviewed lawsuits against the hospital, considered property purchases, approved medical staff appointments and examined internal audits, according to the agenda of its planned executive session.

Dr. Ron Anderson, Parkland's president and CEO, said he was not concerned that an increasing amount of the public hospital's business was being conducted in private. "What they are asking to be in executive session for is within their rights," he said.


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