Ralph H. Johnson VA Medical Center
Monthly Report from the Director
Director’s Special Message to Stakeholders
Scott R. Isaacks, FACHE
Medical Center Director
VA OIG Report
As many of you know, our practice at the Ralph H. Johnson VA Medical Center since my appointment as Medical Center Director in 2014, has been to keep you, our patients and partners, informed as to what is going on in your medical center here in Charleston. This commitment to transparency is not only evidenced by these monthly stakeholder messages, but by many other mechanisms that we utilize to provide information to you. So, I wanted to share some information on a recent report that just came out related to your VA. On the afternoon of December 20, 2016, the VA OIG released a report related to Charleston VAMC’s Non-VA Community Care (NVCC) consult practices in 2013. Below, you will find our full statement to the media outlining details on the findings of this review.
The bottom line is that this was a review of allegations related to administrative processes for clinical consult tracking from several years ago. While the report did not substantiate any wrongdoing on the part of any VA employee nor did it find that this VA was out of compliance with any VA policy, it did find one administrative process that could be improved upon. The noteworthy part of this one recommendation was that the OIG determined that this process had not only been improved based upon this review, but actually determined that the process had been improved long before this review even took place. The review also determined that there was no negative patient outcomes based upon any of the practices that were assessed as part of the review and that your VA is in full compliance with VA policy related to consult processes. Based upon this, though extensive OIG reviews like this almost always result in multiple recommendations with actions that must be taken in the future to close the review out, your VA didn't have any future actions to be taken and the OIG has fully closed this review. This review and report truly demonstrate the substantial improvements that this facility has made over the past several years that would not have been possible without the support of you, our patients.
We also wanted to make you aware that this report was followed by a story in today’s Post and Courier that included information on an individual patient consult assessed as part of this overall OIG review of 1,200 consults. The Post and Courier accurately states that this case was reviewed extensively by an outside team of experts who found no negative clinical impact to this patient due to the administrative processes utilized in 2013 and that the OIG agreed with their assessment and closed the recommendation prior to the issuance of the report. However, it should also be noted that the patient consult was not closed prior to the Veteran receiving the consult appointment as stated in The Post and Courier. If any of you or if any veteran that you speak with has further questions about this review, we would encourage you to contact us as we would be happy to discuss in more detail.
As our message has been and will continue to be - we want each of you to know that, here at your VA, we are determined to provide you the best care and services anywhere and to improve every day for our Veterans. Your partnership is a major part of helping us do just that because it is through your feedback that we learn, and it is through your support and interactions that Veterans across the Lowcountry can rest assured their hospital – their VA – is providing the best quality, timely care to meet their needs. Thanks for allowing us the privilege of providing your health care and it is our hope that each of your have a wonderful holiday season and a very happy new year.
Statement to the Media:
Since 2013, Charleston VAMC has risen to the level of one of the highest ranked VA medical centers in the nation for clinical quality and efficiency. In 2016, VA OIG Office of Audits and Evaluations conducted a review of three allegations sent to VA OIG in 2013 regarding Charleston VAMC’s Non-VA Community Care (NVCC) consult practices. We are pleased that these allegations were reviewed extensively and that this investigation is now closed with no pending recommendations or further action required. Additionally, Charleston VAMC has received confirmation from OIG that there are no further ongoing investigations of this medical center related to this matter. With this review, OIG reviewed more than 1,200 NVCC consults from 2013. As a result of the review, one allegation was not substantiated. One allegation related to the scanning of medical records was substantiated but there was no recommendation as the administrative process followed by Charleston VAMC in 2013 is now national VA policy. The third allegation was partially substantiated, but the recommendation related to this issue was closed prior to issuance of the report. This recommendation was related to overall tracking processes for timely consult management. While Charleston VAMC’s procedures at the time of this review were not out of alignment with facility and national policy, the processes in place in 2013 could be and have been improved upon. Like many processes over the last several years, Charleston VAMC made improvements that allow for a more robust consult tracking system more than a year ago that is in full compliance with current VA policy. As part of the review, there was also initially a concern related to one patient whose care may have been negatively impacted by the administrative processes in place during 2013. Based upon this concern, at the request of the OIG, Charleston initiated an expert clinical panel review. As was determined on all of the patients assessed as part of the overall review, the expert panel determined that there was no adverse clinical outcome related to this specific patient and the OIG agreed with this assessment and, therefore, closed this recommendation prior to issuance of the report. Charleston VAMC continues to strive each day to provide the highest quality care and care coordination with community providers for the more than 69,000 Veterans we are privileged to serve, while partnering with our patients and staff in an ongoing effort to continuously improve each and every service we are privileged to offer our Veterans throughout the Lowcountry.