Thursday, February 5, 2009
VAOIG of Northern Arizona VA
Combined Assessment Program Review of the Northern Arizona VA Health Care System Prescott, Arizona 02/05/09. The purpose of the review was to evaluate selected operations, focusing on patient care administration and quality management (QM). During the review, we provided fraud and integrity awareness training to 266 system employees. The review covered eight operational activities. The system complied with selected standards in the following five activities: (1) coordination of care, (2) pharmacy operations and controlled substances inspections, (3) QM, (4) staffing, and (5) survey of healthcare experiences of patients. We identified the system’s professional practice evaluation as an organizational strength. We made recommendations for improvement in the following three activities: (1) medication management, (2) environment of care, and (3) emergency/urgent care operations. VAOIG
Shinseki Works to Reduce Claims Backlog
VA Secretary Shinseki Working To Reduce Claims Backlog, Calls for 'Timely' Budget 02/05/09. In his first testimony before the House Committee on Veterans' Affairs on Wednesday, Department of Veterans Affairs Secretary Eric Shinseki said that he is working to reduce the six-month delay in paying veterans' disability claims and wants to move quickly in adopting an all-electronic claims system, the AP/Kansas City Star reports. KaiserNetwork.org
Tuesday, February 3, 2009
New Reports From the VAOIG
Combined Assessment Program Review of the Central Arkansas Veterans Healthcare System, Little Rock, Arkansas 02/04/09. The purpose of the review was to evaluate selected operations, focusing on patient care administration and quality management (QM). During the review, we provided fraud and integrity awareness training to 627 system employees. The review covered eight operational activities. The system complied with selected standards in the following four activities: (1) coordination of care, (2) emergency/urgent care operations, (3) staffing, and (4) survey of healthcare experiences of patients. We identified transforming care at the bedside as an organizational strength. We made recommendations for improvement in the following four activities: (1) environment of care, (2) pharmacy operations and controlled substances inspections, (3) QM, and (4) medication management.
Combined Assessment Program Review of the VA Central Iowa Health Care System Des Moines, Iowa 02/03/09. The purpose of the review was to evaluate selected operations, focusing on patient care administration and quality management (QM). During the review, we provided fraud and integrity awareness training to 88 employees. The review covered eight operational activities. The system complied with selected standards in the following two activities (1) staffing and (2) survey of healthcare experiences of patients. We identified the telepharmacy program and QM program redesign as organizational strengths. We made recommendations for improvement in the QM program, environment of care, coordination of care, pharmacy operations, medication management, and emergency/urgent care operations.
Review of Allegations of Mismanagement, Central Alabama Veterans Health Care System 02/03/09. In response to correspondence from the Chairman, Senate Committee on Veterans Affairs and the Chairman, House Committee on Veterans Affairs,the Office of Inspector General referred eight allegations of mismanagement at the Central Alabama Health Care System to the Director, Veterans Integrated Systems Network 7 (VISN) for a response. The VISN did not substantiate three of the allegation and the conclusions were supported by the documentation provided. The VISN partially substantiated three of the allegations and took corrective action, which included issuing a bills of collection to Emergency Room nurses who were paid at the wrong rate and to a physician who was inappropriately paid a retention bonus. The remaining two allegations involved contracts awarded to purchase the services of two retired VA employees. Although the VISN did not substantiate the allegations, based on our review of the documentation, we concluded that both contracting actions violated Federal acquisition regulations. There was no justification for awarding these procurements without competition. The Statement of Work to procure the services of the Financial Manager was inadequate and the purchase order issued to procure the services for the Credentialing and Privileging office did not include a Statement of Work. The purchase order for the services of a Financial Manager was issued against a Federal Supply Schedule contract that was not authorized to sell the services requested. In addition, the services were personal services and the duties and responsibilities included inherently governmental functions. VA does not have authority to issue contracts for personal services and it is improper to contract for inherently governmental functions. The VISN Director concurred with our findings and recommendations and implemented a plan to take corrective action.
Healthcare Inspection Mammography, Cardiology, and Colonoscopy Management Jack C. Montgomery VA Medical Center Muskogee, Oklahoma 02/03/09. This review was done at the request of Senator James Inhofe to determine the validity of allegations regarding delays in mammography services, cardiology consult responses, and scheduling colonoscopy procedures at the Jack C. Montgomery VA Medical Center. We determined that in 2007 patients did not consistently receive mammograms in a timely manner, cardiology consultation requests were not always scheduled within the required timeframe, and waiting times for scheduling colonoscopies was generally excessive. We substantiated that a subject colonoscopy patient did not receive a screening colonoscopy as requested and that a diagnostic colonoscopy was not scheduled within 60 days. We could not substantiate or refute whether primary care providers were notified regarding the status of requests from the three services. Prior to our visit, management had already implemented initiatives to correct the issues regarding delays. However, management needed to discuss the subject patient colonoscopy concern with Regional Counsel to determine whether this case met disclosure requirements. Management and the Regional Counsel have since determined that the case did not require disclosure; we consider this case closed.
Combined Assessment Program Review of the VA Central Iowa Health Care System Des Moines, Iowa 02/03/09. The purpose of the review was to evaluate selected operations, focusing on patient care administration and quality management (QM). During the review, we provided fraud and integrity awareness training to 88 employees. The review covered eight operational activities. The system complied with selected standards in the following two activities (1) staffing and (2) survey of healthcare experiences of patients. We identified the telepharmacy program and QM program redesign as organizational strengths. We made recommendations for improvement in the QM program, environment of care, coordination of care, pharmacy operations, medication management, and emergency/urgent care operations.
Review of Allegations of Mismanagement, Central Alabama Veterans Health Care System 02/03/09. In response to correspondence from the Chairman, Senate Committee on Veterans Affairs and the Chairman, House Committee on Veterans Affairs,the Office of Inspector General referred eight allegations of mismanagement at the Central Alabama Health Care System to the Director, Veterans Integrated Systems Network 7 (VISN) for a response. The VISN did not substantiate three of the allegation and the conclusions were supported by the documentation provided. The VISN partially substantiated three of the allegations and took corrective action, which included issuing a bills of collection to Emergency Room nurses who were paid at the wrong rate and to a physician who was inappropriately paid a retention bonus. The remaining two allegations involved contracts awarded to purchase the services of two retired VA employees. Although the VISN did not substantiate the allegations, based on our review of the documentation, we concluded that both contracting actions violated Federal acquisition regulations. There was no justification for awarding these procurements without competition. The Statement of Work to procure the services of the Financial Manager was inadequate and the purchase order issued to procure the services for the Credentialing and Privileging office did not include a Statement of Work. The purchase order for the services of a Financial Manager was issued against a Federal Supply Schedule contract that was not authorized to sell the services requested. In addition, the services were personal services and the duties and responsibilities included inherently governmental functions. VA does not have authority to issue contracts for personal services and it is improper to contract for inherently governmental functions. The VISN Director concurred with our findings and recommendations and implemented a plan to take corrective action.
Healthcare Inspection Mammography, Cardiology, and Colonoscopy Management Jack C. Montgomery VA Medical Center Muskogee, Oklahoma 02/03/09. This review was done at the request of Senator James Inhofe to determine the validity of allegations regarding delays in mammography services, cardiology consult responses, and scheduling colonoscopy procedures at the Jack C. Montgomery VA Medical Center. We determined that in 2007 patients did not consistently receive mammograms in a timely manner, cardiology consultation requests were not always scheduled within the required timeframe, and waiting times for scheduling colonoscopies was generally excessive. We substantiated that a subject colonoscopy patient did not receive a screening colonoscopy as requested and that a diagnostic colonoscopy was not scheduled within 60 days. We could not substantiate or refute whether primary care providers were notified regarding the status of requests from the three services. Prior to our visit, management had already implemented initiatives to correct the issues regarding delays. However, management needed to discuss the subject patient colonoscopy concern with Regional Counsel to determine whether this case met disclosure requirements. Management and the Regional Counsel have since determined that the case did not require disclosure; we consider this case closed.
New From U.S. Medicine
Legislators: VA Document Shredding Erodes Public Confidence 02/03/09. Incidents of veterans’ documents being slated for shredding when they should not have been has further eroded the public’s confidence in the Department of Veterans Affairs (VA), legislators told VA offi cials last month. Legislators placed the blame on VA’s dependence on paper files in its benefi ts offices and the still spotty transition of information between VA and the Department of Defense (DoD), along with a lack of proper oversight in handling the shredding incidents.
2008 Year in Review—VHA Healthcare: Continuing in Quality, Prepared for Challenges 02/03/09. In 2009, Americans will see a new president, new policies and new realities. In these changing times, however, our nation’s veterans will be able to rely on the same consistent quality healthcare they have come to expect from the Department of Veterans Affairs (VA). At VA, it is our honor and privilege to serve the most deserving patients in the United States—those who have served and sacrificed for all Americans in our nation’s armed forces. The Veterans Health Administration (VHA) has more than 230,000 employees who serve more than 1 million patients a week across the nation.
2008 Year in Review—VHA Healthcare: Continuing in Quality, Prepared for Challenges 02/03/09. In 2009, Americans will see a new president, new policies and new realities. In these changing times, however, our nation’s veterans will be able to rely on the same consistent quality healthcare they have come to expect from the Department of Veterans Affairs (VA). At VA, it is our honor and privilege to serve the most deserving patients in the United States—those who have served and sacrificed for all Americans in our nation’s armed forces. The Veterans Health Administration (VHA) has more than 230,000 employees who serve more than 1 million patients a week across the nation.
New VA Assistant Secretary Named
Duckworth Tapped for VA Assistant Secretary 02/03/09. President Barack Obama has announced his intent to nominate L. Tammy Duckworth, director of the Illinois Department of Veterans Affairs, to be the Assistant Secretary of Public and Intergovernmental Affairs for the Department of Veterans Affairs. VA
Sunday, February 1, 2009
Brain Chemistry & PTSD
Brain Chemistry Plays Important Role in PTSD 0/01/09. The complex emotional and mental systems that have put humans at the top of the food chain can be a detriment when dealing with extreme stress, Dr. Southwick noted. “Animals rarely experience damage from their own stress response, because animals can turn off their stress response,” he explained. “Humans can become stressed from ideas, from perceptions, thoughts and emotions. This rumination can activate the stress response. And when can this stress response cause the most damage? When the stress is unremitting.” U.S. Medicine
Information Sharing Between VA and DoD.
VA and DoD Still Working on Information Sharing 0/01/09. A group of officials from the Department of Defense (DoD) and Department of Veterans Affairs (VA) said that progress is being made in sharing electronic health information between the two departments and that they are on track to meet the requirements of the National Defense Authorization Act of 2008 that directs them to have their electronic health record capabilities and systems fully interoperable by Sept. 30, 2009. U.S. Medicine
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