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Charlie Norwood VA Medical Center brought in help to complete 5,100 unresolved consults

Thursday, Nov. 21, 2013 7:41 PM
Last updated Friday, Nov. 22, 2013 1:44 AM
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Health care administrators at the Charlie Norwood Veterans Affairs Medical Center said Thursday that the hospital botched its gastrointestinal program so badly that it had to re-engineer its floor plan and bring in extra personnel and equipment to handle a consultation case­load that topped 5,100 unresolved diagnostic screenings last year.

The large-scale effort, which was launched in August 2012 and completed three months later, helped the facility determine appropriate treatment plans for 4,560 patients and reduce its backlog to 540 unresolved consults, Director Bob Hamilton said.

However, he said Thursday that more than 50 veterans continue to wait for an appointment and that three cancer patients, who were not seen in time by the overworked gastrointestinal program, died between 2011 and November 2012 while in the course of receiving medical care.

Citing patient confidentiality laws, Hamilton declined to release the victims’ names. He said he believes backlog problems were focused on the program and that his administration will continue to conduct patient mortality reviews to ensure the standard of care has been met.

“All of us at the Charlie Norwood VA Medical Center are deeply saddened by the loss of any veteran at our facility,” said Hamilton, a 30-year Air Force health care administrator who took over the hospital in July 2012. “We offer our sincerest condolences to veterans affected by delays in GI care and families who have lost a loved one.”

Hamilton, the former leader of the Wilford Hall Medical Center in Texas, said he first realized the center had significant delays in gastrointestinal consults a month after he arrived in Augusta.

At the height of the problem, Hamilton estimated the gastrointestinal program had 5,100 unresolved consults.

“Patients were in the system, but there was very little activity associated with getting them an appropriate treatment plan,” Hamilton said.

He attributed some of the problem to the Department of Veterans Affairs shifting its policies in 2011 to offer more screening colonoscopies. As a result, Charlie Norwood was soon flooded with colonoscopy requests and did not have the resources or procedures in place to handle the caseload.

In order to reduce the surge in consults, Hamilton said Charlie Norwood brought in extra personnel for two to three months; leased and purchased additional scopes; and even re-engineered the hospital to increase space and create a more optimal patient flow.

Administrators also began distributing a blood test for patients to submit stool samples themselves.

“Part of the issue was really getting to the bottom of identifying who needed the test and how we could get them in for a consult in a timely manner,” said Dr. Michael Spencer, the chief of staff at the medical center.

Spencer said the center typically averages about 20 colonoscopies per day. At the height of the gastrointestinal backlog, the hospital was doing more than 70 per day.

“Our tracking mechanisms were nothing like what we have established in the meantime, and as we went through those consults, there were some patients that had already received a colonoscopy at another site,” he said.

While the delay in care has largely been tied to former Director Rebecca Wiley, who was leader of the facility when the problem escalated, Spencer said it was not all her fault.

“There were many people involved and opportunities to correct,” he said. “Just like it takes a team to deliver the best medical care possible, there were many touches of these individuals, and to attribute it to one entity I think would be an error.”

Wiley’s tenure in Augusta lasted from February 2007 to December 2010. She was named director of the Williams Jennings Bryan Dorn Veterans Medical Center in Columbia in November 2011, almost a year after she left Augusta and the city’s VA center lost full accreditation.

According to a 2012 report from the VA Inspector General’s Office, Wiley is connected to five care-related injuries or deaths at Charlie Norwood and nearly 90 percent of its unresolved consults. Additionally, the inspector general found that mismanagement during some of Wiley’s tenure in Columbia contributed to a backlog of nearly 4,000 gastrointestinal appointment delays, which in turn led to 19 instances of serious injury and six patient deaths.

In light of the allegations, the House Committee on Veterans Affairs in late Sep­tem­ber requested copies of all current accounts of appointment backlogs and patient injuries. It also asked for any records reflecting performance reviews, pay bonuses and disciplinary actions issued since 2002 to those who oversee patient safety in Augusta.

Hamilton said his staff fulfilled all records requests to corporate and regional offices three weeks ago. Curt Ca­shour, the committee’s communications director, said Thursday that the “VA has not responded to the committee’s attached information requests.”

Spencer said Thursday that the medical center has built a system to track the timelines of colonoscopy delivery and that any patient suspected to have cancer either through weight loss or positive stool sample are scheduled for a screening within 30 days. He said depending on medical history, patients can be seen the same day or by the end of the week.

“We are very attentive to tracking incidents, not just those related to GI (gastrointestinal), but every incident throughout our facility, and we definitely know that there have not been any similar cases since we wrapped up our cleanup efforts in early November of last year,” Spencer said.

Hamilton said the experience has forced the VA as a whole to look more broadly at all consults and to make improvements in all specialties.

“We are a much better organization today than we were a year ago,” he said. “Our access, our consult management and our quality indicators have all improved significantly. There is no comparison of where we are today to where we were a year ago when this particular issue became known to us.”

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Sweet son
9716
Points
Sweet son 11/21/13 - 09:34 pm
6
1
Wiley should be fired and Hamilton should be commended for

cleaning up her mess! Glad that Mr. Hamilton has stepped up and taken responsibility for the hospital and instituted programs to help our veterans.

Sounds like Ms. Wiley is not through making messes! They seem to follow her around. Wonder why?

Conservative Man
5305
Points
Conservative Man 11/21/13 - 10:11 pm
8
2
Hmmm...

....isn't the VA healthcare system in essence a "government run" healthcare system?

Answer....YES.

Therefore, I submit that we in the civilian population will see the very same outcomes when Obamacare is fully implemented...

There are no death panels outright.....

The WHOLE SYSTEM is one gigantic death panel.....

mwnewton
14
Points
mwnewton 11/22/13 - 01:29 am
10
1
Mr. Hamilton shouldn't be commended...

I had to wait over a year while urinating blood and no one did anything. I finally escalated my problem and lo and behold, I had a dangerous papillary bladder cancer that was mis-diagnosed. Then the cover up started. Next, I discovered they had not been monitoring my kidneys (especially after kidney failure and dialysis) and found that my Uric Acid had never been taken in over 10 years. I had to go to an outside doctor to find out what was wrong with me. The VA is an assembly line of poor care by students doing their internships... and doctors and nurses counting time until they retire. Walk the halls of both the downtown and uptown VA Hospitals and notice how many workers are standing around talking, shopping and just doing nothing. And if you get in a phone conversation it won't last more than 5 minutes... they'll tell you they have to get off the phone because they have 2-3 veterans waiting. I have heard that so much that it must be an orientation point for employees. They are slowly killing people at those hospitals.

justus4
99
Points
justus4 11/22/13 - 03:45 am
0
0
This story is making both SC
Unpublished

This story is making both SC & GA VAs look dangerous compared to others in the nation. Having veterans die due to medical shortcomings is unacceptable and someone should be held accountable. Because if they are getting gastrointestinal consults wrong, what else are they getting wrong? Pink slips should go out along with terminations. The country deserves better!

JimS
150
Points
JimS 11/22/13 - 08:36 am
3
1
The Only Government Branch,
Unpublished

The Only Government Branch, the Executive and it's entire Cabinet, federal and states, consistently not only doing for us Vets but the Military personal and their Families, Finally, from day one, started even before, and the first oath to office!!!

The Country, through their representatives certainly aren't, the long underfunded, decades now and especially the past decade plus:

RM: "We got a huge round of tax cuts in this country a few weeks before9/11. Once 9/11 happened and we invaded Afghanistan, we kept the tax cuts anyway.
How did we think we were going to pay for that war? Did we think it was free?
Then, when we started a second simultaneous war in another country, we gave ourselves a second huge round of tax cuts. After that second war started. The wars, I guess, we thought would be free, don`t worry about it, civilians. Go about your business." 23 May 2013

"If military action is worth our troops’ blood, it should be worth our treasure, too" "not just in the abstract, but in the form of a specific ante by every American." -Andrew Rosenthal 10 Feb. 2013

"12 years also is a long time. We now have a lifetime responsibility to a generation of service members, veterans and their families." Dr. Jonathan Woodson 11 Sep. 2013: With 9/11 Came Lifetime Responsibility

As those hawks and oh so patriotic supporters loves their wars for free, especially the decades of results from!!

USN All Shore '67-'71 GMG3 Vietnam In Country '70-'71

JimS
150
Points
JimS 11/22/13 - 08:37 am
3
0
Army Times Oct. 16, 2008 - VA claims found in piles
Unpublished

Army Times Oct. 16, 2008 - VA claims found in piles to be shredded

CNN iReport October 25, 2008 - House Vets' Committee To Probe VA Shredder Scandal

Tampa Bay Times Oct 27, 2008 - Hundreds of VA documents improperly shredded, review finds {Tampa Bay Times search page and series of articles}

CBS News February 11, 2009 - Veterans' Claims Found in Shredder Bins

And more disturbing in relation to even before and through the early years of the Afghanistan, quickly abandoned missions of, and Iraq occupations, this:

ProPublica and The Seattle Times Nov. 9, 2012 - Lost to History: Missing War Records Complicate Benefit Claims by Iraq, Afghanistan Veterans
"DeLara's case is part of a much larger problem that has plagued the U.S. military since the 1990 Gulf War: a failure to create and maintain the types of field records that have documented American conflicts since the Revolutionary War."

griff6035
3904
Points
griff6035 11/22/13 - 08:39 am
3
0
Augusta VA

I have been in the VA Health care system for more than (22) years and give them a B+ for my Care. However, I agree with the post about Employees walking the halls, stopping to chat about family members and other unrelated VA business. I only have hearing in one ear and have no problem overhearing conversations between some of the employees. Also some of the clerks at the check in stations are not very friendly. JMO.

ymnbde
9207
Points
ymnbde 11/22/13 - 08:45 am
4
1
you can't call them "glitches"

when people die... welcome to our future

teaparty
11313
Points
teaparty 11/22/13 - 09:37 am
2
1
JimS said, 'RM: "We got a
Unpublished

JimS said, 'RM: "We got a huge round of tax cuts in this country a few weeks before9/11. Once 9/11 happened and we invaded Afghanistan, we kept the tax cuts anyway.
How did we think we were going to pay for that war? Did we think it was free?
Then, when we started a second simultaneous war in another country, we gave ourselves a second huge round of tax cuts. After that second war started. The wars, I guess, we thought would be free, don`t worry about it, civilians. Go about your business." 23 May 2013'
Revenue actually went up after Bush's tax. Please try to get the facts correct. JFK, Reagan, and George W. Bush understood that reducing taxes has a simulative effect on economic activity which leads to an increase in government receipts.
http://blogs-images.forbes.com/mikepatton/files/2012/10/Federal-Revenue-...

Marinerman1
4345
Points
Marinerman1 11/22/13 - 09:41 am
1
0
I Just Want To Know

WHERE is Rebecca Wiley NOW ??

itsanotherday1
40467
Points
itsanotherday1 11/22/13 - 10:22 am
2
1
Close down VA hospitals

Years ago I stated, and still believe, the VA medical system should be allowed to wither on the vine.

To minimize impact on employees, I would not close it outright. I would start issuing insurance to all eligible personnel as they separate from the military, leaving the current VA eligible people in the system. As they age and pass on, the VA shrinks until it can be closed, and any remaining veterans can be given insurance.

I cannot imagine that providing insurance for veterans could be any more costly than the VA medical system, and the huge plus is they get higher quality care in the private market.

itsanotherday1
40467
Points
itsanotherday1 11/22/13 - 10:23 am
1
0
Mariner man

She runs the Dorn VA in Columbia.(it is a mess too)

Little Lamb
43990
Points
Little Lamb 11/22/13 - 11:31 am
1
1
Style

Cub reporter Wesley Brown wrote:

. . . Hamilton said Charlie Norwood brought in extra personnel for two to three months. . . .

I don't think ol’ Charlie actually did that. I think it would be better reporting to say "Norwood Med. Center brought in extra personnel," or even better, "the VA Med. Center brought in extra personnel."

Little Lamb
43990
Points
Little Lamb 11/22/13 - 11:34 am
2
1
Death Panels

Conservative Man got it right with his 9:11 comment.

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