Thursday, June 29, 2017

Veterans Affairs Office of Inspector General (OIG) in Washington, D.C., United States for Thursday, 29 June 2017 "Healthcare Inspection Dermatology Clinic Staffing and Other Concerns (2012-2014)"

Veterans Affairs Office of Inspector General (OIG) in Washington, D.C., United States for Thursday, 29 June 2017 "Healthcare Inspection Dermatology Clinic Staffing and Other Concerns (2012-2014)"

Bookmark and Share
Veterans Affairs Office of Inspector General (OIG).
OIG conducted a Combined Assessment Program (CAP) review at the Dayton VA Medical Center (facility), Dayton, OH, during the week of February 2, 2015. Prior to the site visit, OIG deployed an electronic employee survey regarding patient safety and quality of care known as the Employee Assessment Review (EAR). An EAR respondent reported that during Quarters (Q) 3 and 4, fiscal year (FY) 2012, and FYs 2013 and 2014: a) Patient Business Service (PBS) schedulers assigned on a temporary basis to cover the Dermatology Clinic were not adequately trained in its specific scheduling practices; therefore, appointments were not consistently scheduled in accordance with preferred dates. b) PBS schedulers did not return calls to patients in a timely manner; (c) As a result, Dermatology appointments were not scheduled timely; (d) One of 20 patients with scheduling delays had a clinically significant adverse outcome as a result. OIG’s goal is to conduct inspections, report on conditions, and provide information that is timely and useful for agency managers and other stakeholders. In this case, the deficient conditions dated back several years and had since been corrected by facility managers. We therefore summarized the allegations, described the conditions that existed at the time of the allegations, and outlined the sequence of events in FYs 2012–2014 focusing on facility corrective actions. OIG also performed a look-back of patients diagnosed with new melanomas or other skin cancers from FY 2013 through Q3 FY 2016 and provided a status of Dermatology Clinic-related operations as of Q4 FY 2016. In 2012, the Dermatology Clinic lost its permanently assigned PBS scheduler. PBS schedulers had to cover the Dermatology Clinic and other specialty care clinics during FYs 2012–2014 (and in Qs 1 and 2 FY 2015). The Chief of Dermatology Service regularly reported the staffing challenges to leadership. Documentation showed that clinical and administrative managers attempted to work together to improve clinic access and timeliness. While we substantiated specific instances of inadequate scheduling practices, poor follow-up to patient telephone calls, and delayed appointments during the time that PBS schedulers covered the Dermatology Clinic, we did not substantiate systemic deficiencies in those areas. While we substantiated scheduling delays, we did not substantiate patients experienced clinically significant adverse outcomes in the cases provided by the survey respondent or in our look-back of patients diagnosed with new melanomas or other skin cancers FY 2013–Q3 FY 2016. We made no recommendations.

Veterans Affairs Office of Inspector General (OIG)
801 I Street North West
Washington, DC 20536, United States
800-827-1000
-------
Veterans Affairs Office of Inspector General (OIG) in Washington, D.C., United States for Thursday, 29 June 2017 - Review of Alleged Misuse of Resources by VHA’s Strategic Investment Management, Business Architecture Division"

Bookmark and Share
Oversight Reports for Veterans Affairs Office of Inspector General (OIG).
In February 2015, the Office of Inspector General received an anonymous Hotline complaint stating that the Veterans Health Administration’s (VHA) Strategic Investment Management, Business Architecture Division misused Government funds when it purchased Troux Technologies’ Architect software. The complainant also stated that VA had project management and architecture tools available; and therefore the purchase of this software was a duplication of existing software functionality. The OIG conducted this review to determine the merits of the allegations. We did not substantiate the allegation that VHA acquired Troux Technologies’ Architect software. However, VHA procured other Troux Enterprise Portfolio Management (EPM) tools, including Troux Navigate for a report-creation capability and Troux Insight as a business analysis engine. We did not substantiate the allegation that the purchase of other Troux services was a duplication of existing VA project management and architecture software functionality. At the time of the allegation, VHA was developing EPM capabilities through a contract with Troux Technologies, Inc. Prior to awarding the contract to Troux Technologies, Inc., VHA conducted a review of business activities and identified functionality gaps for portfolio management. VHA’s “Alternatives Analysis Review,” provided several possible vendor solutions to address the gaps, one of which was Troux EPM software. The analysis identified weaknesses within VA existing systems inventory and noted that the current toolset could not provide portfolio management functionality without extensive modification. We conducted a review of VA’s systems inventory and found no EPM capability that met VHA’s requirements. We did not substantiate the allegations. Accordingly, we have no recommendations for improvement. Management concurred with our report and did not provide any comments.

Veterans Affairs Office of Inspector General (OIG)
801 I Street North West
Washington, DC 20536, United States
800-827-1000
-------
Military Health System in Washington, D.C., United States for Thursday, 29 June 2017 "Sexually transmitted infections: By any other name, they're preventable"

Health.mil

STI

Sexually transmitted infections: By any other name, they're preventable

Navy Petty Officer 1st Class Oliver Arceo draws blood from a sailor at the Naval Air Station North Island medical clinic in Coronado, California, for routine HIV testing. (U.S. Navy photo by Petty Officer 1st Class Marie Montez)
FALLS CHURCH, Va. — The term for germs spread through sexual contact has changed over the years, from venereal diseases to sexually transmitted diseases and now, sexually transmitted infections or STIs. But one thing hasn’t changed: They’re avoidable.
“STIs are totally preventable by practicing abstinence or monogamy, or using latex condoms 100 percent of the time,” said Dr. Don Shell, director of disease prevention, disease management, and population health policy and oversight in the Office of the Assistant Secretary of Defense for Health Affairs, Health Policy Oversight.
STIs is the preferred term because it’s more precise, said Dr. Jose Sanchez, deputy director of the Armed Forces Health Surveillance Branch. The bacteria and viruses spread through oral, anal, or genital contact are infections that can cause diseases such as cancers of the mouth, throat, anus, rectum, and penis. They also can cause serious health problems including sterility.
According to the Centers for Disease Control and Prevention, men are less likely than women to get some STIs because the penis is a less penetrable and receptive breeding environment for germs than the vagina. When men do get STIs, they’re more likely than women to have symptoms, and to notice them. So men are more readily able to get STIs diagnosed and treated.
Men need to be vigilant about prevention and treatment, Shell said, not only for their own health but for the health of their sexual partners.
“Untreated STIs can lead to serious health complications,” he said. Chlamydia, for example, is a common STI that results in few complications in men. But in women, it can lead to pelvic inflammatory disease, an infection of the reproductive system organs that may result in infertility.
Syphilis rates are rising in military as well as civilian communities. According to a study published in the September 2015 issue of “Medical Surveillance Monthly Report,” the number of syphilis cases among active-duty service members rose 53 percent from January 2010 through August 2015. Men accounted for almost 89 percent of syphilis cases, and their rates steadily increased every year during the surveillance period. Rates were highest among servicemen 20 to 29 years old.
Medical experts say rising syphilis rates are a significant public health concern because people with syphilis are more likely to have human immunodeficiency virus, or to become infected with it. HIV attacks the immune system and can lead to the incurable disease AIDS. The sores caused by syphilis bleed easily, providing a way for HIV to enter the body during sex. In the MSMR study, about 25 percent of servicemen with syphilis also had HIV.
Bacterial STIs such as syphilis, chlamydia, and gonorrhea can be cured through antibiotics, though some are becoming alarmingly resistant to them, Sanchez said. But viral infections such as human papillomavirus or HPV and herpes are incurable. Medications can manage the symptoms for some viral as well as bacterial STIs.
“The good news is that most STIs are treatable,” Sanchez said. “So we can make an impact on military readiness if we can rapidly detect trends, establish early screenings and diagnostics, and enforce effective treatment strategies.”
Servicewomen are screened for some STIs as part of the annual wellness exam, but servicemen aren’t. All service members are screened for HIV every two years, and before and after deployments. They’re also screened when it’s clinically indicated by health care providers based on symptoms or answers to routine questions about sexual partners and practices. Those who test positive can remain in uniform as long as they’re capable of performing their military duties.
Sanchez said a growing STI concern is HPV, which refers to a group of related viruses. “Of all the STIs we can detect via testing, by far the highest rates of infection are for HPV,” he said.
Nearly all sexually active individuals will contract HPV, Shell said. In many cases, it goes away on its own. If not, it can eventually cause health problems including genital warts and cancer. Vaccines can prevent HPV infections, but they’re recommended for people before they become sexually active. The CDC has recommended HPV vaccination of girls since 2006 and of boys since 2011 to include two doses at ages 9 through 14 years.
Sanchez collaborated with other researchers in an HPV study of 200 servicemen that was published in the May 2015 issue of “Sexually Transmitted Diseases.” Almost 15 percent were already infected upon entering military service. This percentage was higher than what had been previously reported among the male civilian population, Sanchez said. Within 10 years of military service, an additional 34 percent had become infected with HPV.
“This study offered evidence of the potential benefit of an HPV vaccination program for servicemen, Sanchez said. “Preventing HPV infections decreases health problems and long-term health care costs, and increases readiness of the force.”

Read More ...

Keep an eye on your pets this Fourth of July

People watch fireworks during a 2016 Fourth of July celebration at a park near Incirlik Air Base, Turkey. Fireworks and barbecues may be fun ways for people to celebrate the Fourth of July, but they’re no picnic for household pets. (U.S. Air Force photo by Airman 1st Class Devin Rumbaugh)

FALLS CHURCH, Va. — Fireworks and barbecues may be fun ways for people to celebrate the Fourth of July, but they’re no picnic for household pets. The loud noises can cause anxiety that might linger long after the party has ended, veterinarians warn. And ingesting human food and beverages can harm a pet’s health, sometimes turning fatal.
Army Col. Jennifer Chapman, a veterinarian and the chief of plans and operations in the DHA’s Veterinary Service Branch, said the barrage of noise produced by fireworks sparks anxiety because it’s unfamiliar. Fireworks can even startle animals that might be accustomed to loud noises. For example, the horses in the U.S. Army Caisson Platoon are familiar with multigun salutes at Arlington National Cemetery, but the noise associated with fireworks is very different.
“Noise aversion and physiological changes is an active area of research,” said Dr. Kristina McElroy, a veterinary public health officer and the Defense Health Agency’s Defense Support of Civil Authorities coordinator for veterinary services. “There’s indication that noise can sensitize pets so that they became anxious about other things.”
Chapman said the best place for pets during fireworks is indoors, in a spot where they can’t get into anythig or harm themselves. A crate is a great option for pets already familiar with them, she said.
If your pet is outside with you, make sure it’s microchipped and wearing a collar with an ID tag in case it runs off. “You may have the best-behaved dog in the world, but sudden loud noises can cause it to run off or worse, dart into traffic,” McElroy said.
Pets can also undergo behavior modification programs, McElroy said, but the programs take time. Anti-anxiety medications prescribed by a veterinarian can help. “If you’re interested in addressing your pet’s anxiety, talk to your veterinarian about what options may work best for your pet,” she said.
Pre-fireworks meals for people often include alcoholic beverages, grilled meats, and marshmallow-graham cracker-chocolate bar dessert s’mores. People might be tempted to share with their four-legged friends, but dogs and cats are much better off without.
“I could go into all the medical complications that can happen from giving your pet alcohol,” McElroy said. “But simply put, don’t do it. You may think it would make for a great Facebook video, but you’re putting your pet’s health at great risk.”
Similarly, the grilled hamburgers, hot dogs, and chicken that humans enjoy are too fatty and greasy for pets. They can lead to serious complications such as pancreatitis, an inflammation of the pancreas that can cause problems with other organs. Pancreatitis can develop rapidly in cats and dogs and may even require hospitalization.
“Some pets don’t recover from the overindulgence,” McElroy said.
Also, bones are a choking hazard, Chapman said. If a pet does swallow a bone or bone sliver, “it can get trapped anywhere in the gastrointestinal system and cause major problems,” she said. “Chicken bones are the worst.”
As for s’mores, skewers used for roasting marshmallows are a puncture hazard for pets, and chocolate is toxic. “The darker the chocolate is, the more toxic it is because that means it has more of the ingredient they’re unable to metabolize,” Chapman said.
“If you see your pet eating chocolate, definitely call the vet right away,” McElroy said, adding that it’s important to note the size of the pet, and the type and amount of chocolate that was eaten.
“Most cases will require an emergency room visit,” McElroy said. “It’s that serious.”

Read More ...

pets-fireworks
Facebook
Twitter
Google Plus

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

No comments:

Post a Comment