Clipping 1, New Leader Same Problems Persist

#NewSameProblem  Over the next few weeks, I will publish clippings from old Inspector General Reports, General Accounting Office Reports, and Congressional Testimonies.

Here is Clipping 1 from Office of the Inspector General (OIG) Quality Management in the Department of Veterans Affair, Veterans Health Administration, Report Number 8H1-A28-072, Date: February 17, 1998.  The Office of the OIG gives us a history lesson in this report

A. History and Legislative Overview

In the 1970s, VHA [formerly the Department of Medicine and Surgery (DM&S)] established and operated a QA program called the Health Services Review Organization (HSRO)1. HSRO programs featured internal review processes in VA medical centers (VAMCs), as well as external reviews of VAMCs. Together, these external and internal processes comprised VA's Medical QA Program.

"The HSRO consisted of a two-faceted program. The HSRO - Systematic Internal Review (SIR) Program was an integrated QA process that was conducted by VAMC employees."

HSRO-SIR functions and elements consisted of essentially four mandatory parts: 

• Continuous Monitoring included reviews and analyses of medical records, surgical cases (tissue), blood services, therapeutic agents and pharmacy, laboratory, radiology and nuclear medicine, psychiatry programs, commitment usage, restraint and seclusion usage, infection control, surgical and anesthetic complications, autopsies, mortality and morbidity, rejected applications for care, and patient incidents;
• Patient Injury Control reporting included incidents, and QA investigation for unexpected or unfavorable events such as suicides, 1 homicides, falls, assaults, abuse, neglect, allergic reactions, unexpected deaths, and surgical complications;
• Utilization Review; and,
• Credentialing and Delineation of Clinical Privileges,.

Congress addressed "independence" and objectivity issues associated with this structure in 1978.  More on this later….  But, think about the how this oversight may have or should have changed how business was conducted on a daily basis.  It would be great to hear from someone who worked in the VA at that time.

http://www.amazon.com/Veterans-Administration-RTLS-Recommendations-Success-ebook/dp/B00A0MS5MS/