Patients at Department of Veterans Affairs (VA) hospitals do not have adequate protection from doctors with a history of subpar treatment, according to a new report released by the Government Accountability Office (GAO).
Of the four unnamed VA hospitals inspected by the GAO, none were in full compliance with all required procedures for peer review of patient care that leads to adverse outcomes, according to the report. In addition, inspectors found the VA failed to pursue several cases that potentially required disciplinary action.
"When VAMCs [Veterans Affairs medical centers] fail to complete peer reviews in a timely manner…they put patients' safety at risk through potential exposure to substandard care," the report states. "VAMCs may fail to identify problematic providers in a timely manner and take the appropriate actions."
When an adverse event occurs at a VA hospital, there are three levels to the review process, according to the Washington Examiner: Peer review, which involves experienced providers analyzing a patient's treatment to determine its appropriateness, and two levels reviewing the attending physician's competence and culpability for the adverse event. Of these three levels, only peer review is confidential and inadmissible in disciplinary proceedings.
Only one hospital inspected by the GAO performed all initial reviews within the 45-day deadline. Two others failed to meet that deadline more than 20 percent of the time, according to the report.
The GAO made several recommendations to correct these problems, including that the VA:
ensure providers submit all required peer reviews;
ensure the peer review committee completes final review within its 120-day deadline;
clearly outline scenarios that trigger a required peer review; and
require periodic updates on peer review trigger data, including how many doctors have exceeded the triggers.
The report is the latest trouble for the VA. A November investigation found delays and long waits for routine procedures at VA hospitals had led to veteran deaths, FierceHealthcare previously reported.