HJAR Nov/Dec 2022

HEALTHCARE JOURNAL OF ARKANSAS I  NOV / DEC 2022 19 By June 2021, many in the United States considered the COVID-19 pandemic to be over. Arkansas, in particular, was behind the curve in vaccinating state residents, and virus control measures were virtually non- existent outside of private companies’ and individuals’ whims. But healthcare workers knew the truth. Thousands of new COVID cases were still being identified every month, the virus’ mortality rate was close to 2%, and less than a third of state residents had received even one vaccine dose, let alone the full series. As patients poured in, workers at one hospital in South Arkansas found them- selves overwhelmed, understaffed, and losing morale, and on June 4, the general medical staff at Medical Center of South Arkansas took what was described as an unprecedented vote of no confidence in the hospital’s administration in protest of the facility’s COVID protocols. “These doctors, who have dedicated years of practice in this community to take care of the health of this community, have come together to say enough is enough, and have made a unanimous vote of no confidence,” then-MCSA Chief of Staff Ezinne Nwude, MD, told the El DoradoNews-Times the day after the vote. Nwude declined to share details with the newspaper about the issues at the hospital — those would come later — but she said the problems were affecting quality of patient care and staff morale, and she pointed spe- cifically to then CEO Scott Street’s leader- ship as being problematic. “(Street’s) is the first leadership that the general medical staff of this hospital have had enough concern about their practices and policies that they decided to come together and speak up,” she said. Members of the medical staff who partici- pated in the vote sent a letter to the MCSA board of trustees outlining the reasons why they’d lost confidence in the hospital’s leadership. On June 6, the day the first News-Times story about the vote was published, Street sent a memo to hospital staff saying MCSA had “engaged independent counsel” to investigate the issues doctors pointed to. Street also disputed Nwude’s comment that the no confidence vote had been unani- mous. He pointed to the hospital’s Leapfrog Safety Grade, a B; CMS Star Rating, 3 stars; patient surveys, which he said showed 75% of patients “provide a positive overall rat- ing” about their experience at MCSA; and employee surveys, where he said doctors and other employees, on average, rated the hospital higher than 4 out of 5 points. “In fact, both our physician and employee surveys indicated strong engagement, align- ment and overall satisfaction with our hos- pital,” he said. Investigation MCSA is one of six hospitals inArkansas owned by CHS, or Community Health Sys- tems. It’s the only one in South Arkansas; the rest are concentrated in the Northwest corner of the state. According to the hospital’s website, MCSA is “a general acute-care Level III Trauma Center.”The 166-bed facility employs more than 700 healthcare workers and has won numerous awards, including being named among Arkansas Business ’ Best Places to Work in 2020 and Arkansas Business ’ Cat- egory IV Business of the Year in 2021. It’s one of the biggest employers in El Dorado, “As patients poured in, workers at one hospital in South Arkansas found themselves overwhelmed, understaffed, and losing morale, and on June 4, the general medical staff at Medical Center of South Arkansas took what was described as an unprecedented vote of no confidence in the hospital’s administration in protest of the facility’s COVID protocols.” In the midst of the pandemic we all know hospitals were slammed. Nerves frayed as death tolls rose, systems everywhere were overloaded, teams were overworked, people were scared. In El Dorado, Medical Center of South Arkansas physicians had had enough. They lost confidence in the C-suite and enacted not one, but two votes of no confidence in the administration, evoking a rarely played trump card. We asked Caitlan Butler, a reporter with the El Dorado News-Times who covered the play-by- play, to recap what occurred. She kindly agreed, and here is her story.