Wednesday, May 17, 2017

Healthcare Inspection – Quality of Care Concerns of a Surgical Patient, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas for Wednesday, 17 May 2017 - Veterans Affairs Office of Inspector General (OIG) in Washington, D.C., United States

Healthcare Inspection – Quality of Care Concerns of a Surgical Patient, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas for Wednesday, 17 May 2017 - Veterans Affairs Office of Inspector General (OIG) in Washington, D.C., United States

Healthcare Inspection – Quality of Care Concerns of a Surgical Patient, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
OIG conducted an inspection to assess allegations about a surgical patient’s care at the Central Arkansas Veterans Healthcare System (system), John L. McClellan Memorial Veterans Hospital, Little Rock, AR. We did not substantiate that physicians failed to examine the patient every day; electronic health record (EHR) documentation contained daily assessments. We did not substantiate that the patient was in bilateral wrist restraints continuously for over 30 days or that nursing staff did not follow physician orders regarding the patient’s activity level. EHR documentation showed restraints were used but removed periodically and nurses increased the patient’s activity level when ordered to do so. We found the system’s restraint policy did not require notification of system leaders of duration of medical restraint use. We did not substantiate that the use of restraints caused a full thickness tissue loss or that staff failed to address an issue with the patient’s foot and ankle. However, staff did not consistently follow the system’s policy regarding wound care documentation. We substantiated that a request for a transfer was denied but we did not substantiate that the denial was inappropriate. Services the patient needed were not available at the second hospital. We could not substantiate that nursing staff were making bets on how much medication they could give another patient to keep him quiet. The patient had a history of alcohol use but the EHR did not contain documentation that the surgical team offered preoperative
detoxification; it is unknown, however, if the patient would have agreed to the offer. We made three recommendations: (1) ensure a peer review is conducted to determine if the risk of alcohol was adequately assessed and whether inpatient management was reasonable, (2) modify the restraint policy to include leadership notification of patients in medical restraints after specified timeframes, and (3) ensure wound care documentation is consistent with system policy.This service is provided to you at no charge by Veterans Affairs Office of Inspector General (OIG).
-------
Healthcare Inspection —Alleged Program Mismanagement and Other Concerns at the VA Southern Oregon Rehabilitation Center and Clinics, White City, Oregon for Wednesday, 17 May 2017  - U.S. Veterans Affairs Office of Inspector General (OIG) in Washington, D.C., United States
Healthcare Inspection —Alleged Program Mismanagement and Other Concerns at the VA Southern Oregon Rehabilitation Center and Clinics, White City, Oregon
OIG conducted a healthcare inspection in response to allegations regarding program mismanagement and other concerns at the VA Southern Oregon Rehabilitation Center and Clinics (SORCC), White City, OR. Specifically, the complainant alleged that: Home Based Primary Care (HBPC), the Transitional Care Unit (TCU), the Non-Institutional Purchased Care program (specifically, the Homemaker and/or Home Health Aide services (H/HHA)), and the Housing and Urban Development Veterans Affairs Supported Housing (HUD-VASH) program were mismanaged and lacked appropriate oversight; Services, such as occupational therapy, physical therapy, case management, discharge planning, and mental health, were unavailable; Services were denied to patients as a result of other patients receiving services inappropriately; TCU patients’ lengths of stay (LOS) were based on need for reimbursement rather than clinical criteria; H/HHA service hours were inflated; Patients were harmed at the SORCC; Training and educational resources were unavailable for staff. We initially substantiated that H/HHA and HUD-VASH programs lacked appropriate oversight as the Community Care Oversight Committee (H/HHA oversight) and the HUD-VASH program committee did not have required attendance or documentation of relevant program issues as described in Veterans Health Administration (VHA) and SORCC policy. However, based on updated information we received in 2016, we noted new committee leadership, required attendance, and discussion of relevant program issues. We did not substantiate the other allegations. We found the HBPC program and the TCU complied with selected VHA requirements; oversight committees were in place; members attended meetings; and action items were identified, addressed, and resolved. We reviewed selected services and found the patients we reviewed had received required services. We did not receive the names of any patients, and we did not identify any patients, who were denied services. We identified and reviewed the EHRs of 11 TCU patients whose LOS were over 90 days. We found the LOS were appropriate based on the inability of the patients to be fully successful in the traditional SORCC setting or in the community. We did not find an inflation of care needs without clinical justification for H/HHA patients. We found various educational resources were available to staff and that management supported necessary clinical training. We made no recommendations.
This service is provided to you at no charge by Veterans Affairs Office of Inspector General (OIG).-------
Former Massachusetts Police Sergeant Pleads Guilty to Embezzling Funds From Disabled Veterans and Running Fraudulent Tax Preparation Business for Wednesday, 17 May 2017 - Veterans Affairs Office of Inspector General (OIG) in Washington, D.C., United States

Former Massachusetts Police Sergeant Pleads Guilty to Embezzling Funds From Disabled Veterans and Running Fraudulent Tax Preparation Business
Former police sergeant pleads guilty to fiduciary fraud misappropriating funds from the accounts of disabled veterans and other offenses.
This service is provided to you at no charge by Veterans Affairs Office of Inspector General (OIG).-------
U.S. Department of Veterans Affairs CMV - News Update for Wednesday, 17 May 2017 - U.S. Department of Veterans Affairs in Washington, D.C., United States

In Case You Missed It: The Center for Minority Veterans is sharing recent news stories that may be of interest to minority Veterans, service members, and their supporters on a weekly basis.
VA and partner organizations focus resources to provide Veterans with a career path
Chicago program launches jobless Veteran on career path.
#VeteranOfTheDay Bertran F. Wallace
We honor his service.#VeteranOfTheDay Omar Andrews
We honor your service, Omar!
The goal of this contest is to shine the light on our country's Veterans and service members while encouraging the sharing of their images, and foster their passion for photography.
We honor his service.
The goal of this contest is to shine the light on our country's Veterans and service members while encouraging the sharing of their images, and foster their passion for photography.
Veterans Choice Program phone number is 1-866-606-8198.
Keep updated & let us know how we're doing.

VA does not endorse and is not responsible for the content of any external web site links. These sites are provided for informational purposes only.
If you are in crisis and need immediate help, please call 1-800-273-8255 and (PRESS 1) or visit http://www.veteranscrisisline.net/.
Please remember the only secure way to ask personal questions is at
-------
A caregiver's quiet resilience for Wednesday, 17 May 2017 - Military Health System in Washington, D.C., United States

A caregiver's quiet resilience
Petty Officer 1st Class Troha was diagnosed with a neurological condition in December 2015 after 13 years of Service. The Department of Defense Military Adaptive Sports Program helped him regain a sense of identity. (Courtesy photo)“I didn’t know how resilient I was until I had to be,” said Jennifer (Jen) Troha, wife and military caregiver to U.S. Coast Guard Petty Officer 1st Class Robert (Rob) Troha. “It’s amazing what you can do when you’re put in a situation where you just have to do what you have to do.”
As a wife, mother, and caregiver, Jen has her hands full. Never did she imagine she would be caring for a family of eight, including four children and two dogs, while traveling regularly to Paralympic-level adaptive sports training camps and clinics with an ill Service member.
U.S. Coast Guard Petty Officer 1st Class Rob Troha (left) pictured with his wife and caregiver Jen Troha (right) at the 2017 DoD Warrior Games - U.S. Navy Trials in Port Hueneme, California, February 2017. (Courtesy photo)
U.S. Coast Guard Petty Officer 1st Class Rob Troha (left) pictured with his wife and caregiver Jen Troha (right) at the 2017 DoD Warrior Games - U.S. Navy Trials in Port Hueneme, California, February 2017. (Courtesy photo)
And yet, she said, “Here I am. I didn’t realize I had it in me, that’s for sure.”
Petty Officer 1st Class Troha was diagnosed with a neurological condition in December 2015 after 13 years of Service. The
Department of Defense Military Adaptive Sports Program helped him regain a sense of identity.
“Adaptive sports have given him purpose,” said Jen. “His career has been taken and he was raised with the old-fashioned belief that he’s the husband and the father and that he’s supposed to be the provider,” she said. “With all of that taken away, it’s nice for him to have something new to engage with and to focus on; something to keep him thriving.”
Petty Officer 1st Class Troha competed in the February 2017 U.S. Navy Trials in Port Hueneme, California, to earn a spot at the upcoming DoD Warrior Games, and given PO1 Troha’s condition, he will always require a caregiver by his side. Jen has found companionship and support among fellow caregivers on the road.
“We are a very tight-knit group. We face a lot of the same challenges,” she said. “It’s not as simple as caring for our spouses; there are a whole lot of things that go into being a caregiver. The effect it has on your marriage and your family life play a big part. It’s nice to have other people that understand that struggle.”
Many caregivers also face challenges balancing their caregiver responsibilities while also prioritizing self-care – a necessary and conscious effort.
“It’s very easy to get lost in everything that’s going on. And if you’re not careful, the balance is lost with it,” said Jen. “It’s something we actively have to strive for but as long as we don’t forget to carve that time out, then that balance is there.”
She advises other caregivers to take help when it’s offered.
“It’s really important to address your own needs because if you’re not taken care of then you can’t take care of [your Service member]… if you’re not supported, then you can’t support [your Service member]. So, if people offer to help, take them up on it,” said Jen.
As her children, aged six, four, two, and six months, grow up witness to their parents’ experience, Jen hopes they heed one major takeaway: if you fall down, you get back up.
“It’s not like when my husband joined the military, he anticipated that he was going to have any of the struggles he’s had,” she said, “and when you’re faced with a devastating diagnosis or severe psychological problems, you have two choices: you can let it hold you back, you can let it define you, or you can define yourself, get back up, and keep pushing through.”
And that’s what resilience is all about, isn’t it?
Learn more about the Military Adaptive Sports Program and follow the road to the Warrior Games on Twitter @WarriorCare and on Facebook @WarriorCare.
Read More ...
DoD brain injury center opens more sites for military TBI care
The Defense and Veterans Brain Injury Center (DVBIC) recently added traumatic brain injury (TBI) network sites at Fort Gordon, Georgia; Fort Drum, New York; and at the South Texas Veterans Health Care System in San Antonio. These sites help DVBIC spread the word among the military community about the latest in TBI research and treatment according to DVBIC deputy director Katherine Helmick.
The Defense and Veterans Brain Injury Center recently added traumatic brain injury network sites at Fort Drum, New York, Fort Gordon, Georgia and San Antonio.The Defense and Veterans Brain Injury Center recently added traumatic brain injury network sites at Fort Drum, New York, Fort Gordon, Georgia and San Antonio.
“If we want to impact and improve health care for our service members, we need to be where they are,” Helmick said. “This puts us at all five of the VA’s Polytrauma Rehabilitation Centers and at high volume military treatment facilities.”

Greater Access to New Research

DVBIC will bring its knowledge of up-to-the-minute findings on the causes, symptoms and treatment of TBI, so that providers won’t have to hunt down new information on their own. Each location also provides added benefits to DVBIC, which in turn will enable DVBIC to help patients more effectively. For example, the new site at the Department of Veterans Affairs Audie L. Murphy Medical Center in San Antonio, offers DVBIC staff access to VA polytrauma system of care services. These services include rehabilitation centers, support clinic teams, points of contact and transitional rehabilitation programs. DVBIC will be able to learn from patients in San Antonio about what treatments are most effective.
The Fort Drum site in the Guthrie Ambulatory Healthcare Clinic in Watertown, New York, makes it easier for TBI providers in the northeast to learn about new treatments. Before this site opened, these service members traveled all over New England to meet with providers from DVBIC and Walter Reed National Military Medical Center.

Improved Treatment Process

Reducing patient wait times is an important goal for DVBIC. The Dwight D. Eisenhower Medical Center at Fort Gordon operates a TBI outpatient program for a significant number of patients with persistent brain injury concerns. DVBIC will now be on hand to figure out how this population and others like it can receive more efficiently targeted care.
“By looking at referral patterns and researching the range of treatment options throughout the military health care system, we are working with our service TBI partners to find solutions to match patients with the care they need,” Helmick said.

Providers Benefit

Providers appreciate the benefits of the growing DVBIC network. According to John Rigg, site director for TBI at Fort Gordon, the new DVBIC staff will help support and prepare providers who care for TBI patients.
“We’ve been kind of isolated,” said Rigg. “By working together with DVBIC as a network site, we can participate in ongoing research, better collaborate with other experts in the field, and tap into some of the great work being done.”
Disclaimer: Re-published content may have been edited for length and clarity. Read original post.
Read More ...
-------
Questions for MHS? Contact Us
STAY CONNECTED:

Military Health System
The Pentagon
Washington, D.C. 20301, United States
-------

No comments:

Post a Comment