VA Halted Oversight Visits to Troubled Facilities

Tuesday, 10 Jun 2014 06:31 AM

By Elliot Jager

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The scandal over long wait times for VA healthcare has masked a no less pressing deficiency – the poor quality of medicine at some facilities, The Wall Street Journal reported.

The Department of Veterans Affairs suspended a program that between 2005 and 2011 sent medical quality experts to try to improve the way patients were being treated at hospitals where death rates or medical complications were unusually high.

While some VA hospitals provided "five star" quality care, others like those in Augusta, Georgia.; Little Rock, Arkansas; Providence, Rhode Island; Murfreesboro, Tennessee; Oklahoma City; Phoenix; and Puget Sound, Washington, were consistently earning low marks on a range of criteria.

The Augusta facility, for example, had an overall death rate that was 120 percent higher than at the best VA facilities. Its congestive heart failure death rate was also notably higher, and its infection rate for patients with intravenous catheters was double that of top VA facilities.

Even though death rates were growing, the VA stopped sending experts to troubled hospitals like Augusta because top managers felt measuring negative medical outcomes was not actually useful, the Journal reported.

After leaving the position unfilled for over two years, physician Carolyn Clancy was recently appointed to oversee medical quality at VA hospitals. The suspended reviews at poorly performing facilities were restarted a year ago. Those at the bottom rung of performance levels are now annually inspected. Teams are dispatched in 24 hours if a death occurs at a heart-catheterization facility. Clancy said it wasn't always clear why some hospitals did poorly, though sometimes it was because of on-site management.

With all its problems, the VA said its facilities performed about as well, on average, as private hospitals across the country, though its poor performance facilities were worse than poorly performing private hospitals.

The VA operates 127 acute-care and surgical facilities. The system had once been well known for its medical excellence, the Journal reported.

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