CHARLOTTE, NC (Fred Clasen-Kelly and Caroline Metzler/The Charlotte Observer) - In a blistering report released Friday, consultants found widespread and deep-seated flaws in Mecklenburg County's health department, extending from poorly behaving employees to top executives who failed to hold them accountable.
Mecklenburg leaders ordered reviews of the agency after acknowledging in February that two publicly run health clinics did not notify at least 185 women about abnormal Pap smears.
Navigant, a consulting firm, interviewed health department employees, observed operations and analyzed data to compile a report – one which county commissioners will discuss at a meeting Tuesday.
Consultants cite numerous problems, including an outdated electronic medical records system and demoralized staff in the clinics who "feel they do not have the necessary tools to do their work."
But perhaps the strongest criticism was aimed at the agency's management, including Health Director Marcus Plescia, who resigned under pressure last month.
"Staff are not held accountable for their inappropriate behavior or actions by leadership," the report says. "This inaction provides staff with a negative feedback loop that 'bad behavior' is tolerated and there are no consequences for their actions."
"Some managers do not exhibit/model appropriate behaviors for their staff. Staff, also, model these inappropriate behaviors, leading to a bad culture and a inhospitable work environment for staff."
The findings appear to support accounts from health department employees who for months have peppered county commissioners with emails and calls.
They allege that patients who depend on clinics on Billingsley Road in southeast Charlotte and Beatties Ford Road in west Charlotte endure unacceptably long waits for appointments and sometimes receive inaccurate test results for pregnancies and sexually transmitted diseases and other poor care.
Plescia had insisted that critics had mischaracterized the service that patients received and boasted about improvements since his arrival in 2014, including accolades for a "culture of quality."
But consultants noted that patients sometimes wait as long as 50 minutes to check in for appointments.
"Clinical and quality performance standards and metrics minimally exist or are not used to gauge clinical performance," the report says. "The lack of an organized and robust infrastructure has limited MCHD success resulting in patient dissatisfaction, staff and provider dissatisfaction."