The California Department of Health Care Services has restricted Santa Barbara Cottage Hospital’s pediatric intensive care unit from accepting certain new patients.
Since July, the hospital has not been allowed to admit patients into that unit who are under the California Children’s Services program, which provides health care services to chronically ill children under the age of 21.
The Department of Health Care Services said that the hospital’s pediatric ICU has fallen short of the California Children’s Services program standards, with a recent report detailing 49 non-compliance findings and 60 recommendations to remedy these issues.
Most of the deficiencies revolve around staffing, policies and procedures.
Cottage Hospital’s pediatric ICU remains open and continues to care for patients who are not part of the California Children’s Services program.
With the unit’s current amount of staffing and the medical director needing to take on administrative tasks — reducing their clinical commitment — the report said the unit “is not a safe working environment for the physicians and thus not a safe patient care environment.”
The review also said there is no California Children’s Services-paneled pediatric neurosurgeon on the hospital staff or available to provide care in the pediatric ICU.
Another issue the report focused on was that pediatric ICU physicians were not always involved in decision-making for admissions, transporting a patient, and other parts of patient care they should be included in.
“All intensivists reported examples when they wanted to transport a patient whose care was beyond the scope of the PICU team or whose escalation pattern portended decline that would unnecessarily endanger the patient if not transported in which they were prevented from transporting or for which they faced disciplinary actions,” the report said.
Santa Barbara Cottage Hospital is the second hospital restricted from admitting new California Children’s Services patients to its pediatric ICU this year, with the Department of Health Care Services barring John Muir Medical Center in Walnut Creek from accepting these patients earlier this year. Those restrictions were lifted in mid-August.
Cottage Health spokesperson Cristina Cortez told Noozhawk that the pediatric ICU typically cares for two or three patients per month within the California Children’s Services program, making up about 20% of the unit’s patients.
She added that the restriction applies only to admitting patients under the California Children’s Services program into the pediatric ICU. These patients can still access emergency care, acute non-critical care hospital admissions, outpatient care, or any other hospital care.
“Families can continue to seek care as needed,” Cortez said. “We will help navigate care for CCS participants. If we are unable to admit a patient to the PICU due to CCS coverage, we will provide emergency care and coordinate a critical care transfer.
“Most importantly, all of our services remain open and if critical care is needed, we will continue to help families access that level of care for their children.”
The restriction has been in place at Santa Barbara Cottage Hospital since July 11, and Cortez said that, while there is not yet an estimated date for resuming CCS admissions, the hospital has submitted additional documents to the program and is working to fix any problems.
“We are working to resolve this quickly so we can continue offering care for all children in our community, including the CCS program participants for whom access to local care is critical,” Cortez said.
Cortez added that the Department of Health Care Service’s site visit and review was not prompted by patient care concerns, and she said review of data since January 2022 showed zero patient harm events in the hospital’s pediatric ICU.
The provider standards review is available to view here and more information on Santa Barbara Cottage Hospital’s pediatric intensive care unit can be found on the hospital’s website here.