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Adverse instances noted at VA, improvements touted

Friday, Aug 29, 2014 8:09 PM
Last updated Saturday, Aug 30, 2014 2:51 AM
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The Charlie Norwood Veterans Affairs Medical Center appears to be making gradual strides toward erasing long wait times, but federal documents suggest the Augusta hospital still has a ways to go to improve the quality of care patients receive once they’re in the door.

In the past two fiscal years, the hospital has reported 16 “adverse outcomes” to Department of Veterans Affairs’ administration for procedures that took place between April 2010 and September 2013, according to records obtained through the Freedom of Information Act.

The disclosures, 11 of which were reported in 2013 and five in 2014, include seven patients experiencing worsening conditions related to gastrointestinal procedures; two each for specialty care, surgery, and nursing services; and one each for primary care, dental and radiology treatment.

Though the Augusta VA could not comment on circumstances surrounding the incidents, citing patient privacy laws, spokesman Pete Scovill said in a statement Friday that the adverse events were reviewed to indicate areas of “improvement” for the hospital.

“The Veterans Health Administration believes that there is an unwavering ethical obligation to disclose to patients harmful adverse events that may have been sustained during the course of their care at Charlie Norwood VA Medical Center and all medical centers across the nation,” Scovill said in an e-mail. “The cases noted in the document provided to The Augusta Chronicle are cases where a Charlie Norwood VA Medical Center internal review indicated an opportunity for improvement and disclosure to patients was appropriate.”

Reports of botched care follow nearly a year of congressional scrutiny at the hospital for management delaying 4,500 consultations for gastrointestinal patients that in turn, led to four adverse outcomes and three patient deaths in 2011.

In conducting a nationwide audit in May, federal inspectors found more than 15 percent of schedulers at the Augusta VA felt instructed to enter a desired appointment date other than one a patient might have requested, and only 21 percent reported correct usage of the facility’s electronic wait list.

After peaking at 63 patients waiting at least 90 days for an appointment, the Augusta VA’s efforts to eliminate its electronic wait list has stalled at about 30 veterans in the last month, according to the audits’ updated figures released this week.

The hospital and the VA are improving, each announced this week.

The Augusta VA reported Wednesday that its Safe Patient Handling and Mobility Program has resulted in a 77 percent decrease in staff incident rates in fiscal year 2013 compared to 2008 for activities related to lifting, repositioning and transferring veterans.

Two days earlier, the VA announced plans to issue a proposal request for a new medical appointment scheduling system to provide schedulers with cutting-edge, management-based software that will improve access to care for veterans.

According to a news release, the request will be made public by the end of September and eligible vendors will have 30 days to respond.

“When we can put a solid scheduling system in place, this will free up more human resources to focus on direct veterans’ care,” VA Secretary Robert McDonald said of a new system. “As VA recommits to its mission of caring for Veterans and evaluating our actions through the lens of what serves them best, we know a better scheduling system is necessary to provide them the timely, quality health care that they have earned and deserve.”

Progress Report

As of Aug. 15, the Veterans Health Administration has reported:

• Reaching out to over 266,000 veterans to get them off wait lists and into clinics.

• Scheduling about 200,000 new VA appointments nationwide for veterans between May 15 and June 15.

• Referring nearly 912,000 veterans to non-VA care providers in the last two months. That is, more than 190,000 more referrals than the same period in 2013 (721,000).

• Decreasing the number of veterans on the electronic wait list by 57 percent.

• Reducing the New Enrollee Appointment Report from its peak of 63,869 to 1,717.


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