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Healthcare Inspection – Alleged Patient Deaths and Management Deficiencies in Home Based Primary Care, Beckley VA Medical Center, Beckley, West Virginia
OIG conducted an inspection at the request of former Congressman Nick J. Rahall to assess the merit of allegations made by a complainant regarding patient deaths and management deficiencies in the Home Based Primary Care (HBPC) program at the Beckley VA Medical Center, in Beckley, WV. We substantiated that from 2007 through 2012, 25 of 40 patients died while awaiting admission to HBPC. However, we did not find that these patient deaths were associated with a delay in admission to HBPC, as the patients continued to receive care from other health care providers prior to their deaths. We found that from 2008 through July 2012, HBPC staff kept an unapproved wait list in violation of Veterans Health Administration policy. We did not substantiate that HBPC patient scheduling, wait times, and backlogs were mismanaged. We found that, other than the wait list issue cited above, HBPC program managers substantially complied with VHA and facility policies. We substantiated that an HBPC provider changed a patient’s diagnosis by adding a diabetes diagnosis to the patient’s problem list. However, we could not determine that the change was made to obtain prosthetic shoes for the patient. We did not substantiate that HBPC providers inappropriately prescribed antibiotics. We did not substantiate that providers overprescribed opioids or changed patients’ diagnoses in order to prescribe opioids. We made no recommendations.
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Between two worlds: Guard and Reserve nurses perfect professional balancing act for Monday, 8 May 2017 from The Military Health System in Washington, D.C., United States
Between two worlds: Guard and Reserve nurses perfect professional balancing actTheresa Prince, a civilian nurse practitioner and Air National Guard assistant to the Air Force Nurse Corps chief, said that her two careers, while different, have provided her with valuable skills and experiences that help her as a nurse and leader (Courtesy photo from Theresa Prince)Naational Guard and Reserve nurses who also serve as nurses in their civilian careers have a lot to manage: providing care during the week in civilian settings and then performing duties as officers in the United States military during weekend drills. They accomplish all this while balancing a life outside these dual careers. Working as nurses in both worlds simultaneously takes skill, dedication, and a lot of hard work.
U.S. Air Force Col. Theresa Prince is pinned her star, by retired Brig. Gen. Jim Chow and her husband Ken, at McEntire Joint National Guard Base, Eastover, South Carolina, Nov. 7, 2015. (U.S. Air Froce photo by Tech. Sgt. Jorge Intriago)Army, Navy, and Air Force Reserve, as well as the Air National Guard and Army National Guard, make up the military’s Reserve component nurse corps. Some citizen-soldiers, sailors, and airmen join to fulfill career goals; others join for the guidance, leadership, and professionalism of the military. All dedicate themselves not only to excel at what they do, but also carry the patriotic spirit of serving their country.
“For sure, one of the best things I’ve done is joining the Reserve and Guard,” said Brig. Gen. Theresa Prince, a civilian nurse practitioner and Air National Guard assistant to the Air Force Nurse Corps chief. According to the Military Health System, more than 9,000 nurses serve in the Reserve and Guard components. “There are a lot of opportunities out there to excel and you just need to figure out what they are.”
Prince served four years on active duty before transitioning to the Air Force Reserve as a flight medic while also attending nursing school. After moving to South Carolina several years later, she switched to the Air National Guard and has continued to work as a nurse practitioner at the same civilian hospital for the past 21 years.
“Many Reserve nurses work in highly skilled jobs throughout the week and then maintain a lot of those skills [in their reserve position], so they’re truly experts in both of their jobs,” said Prince. Unlike their active duty counterparts, Reserve and Guard nurses can often stay with the same unit for many years – if not their entire career.
Reserve and Guard nurses complete about 40 days of training and once-a-month drill weekends each year, and can be called to active duty status when needed. Although many Reserve positions demand a sizable chunk of time, finding a work-life balance and succeeding in both positions is possible and rewarding. Serving as a leader in the Air National Guard while also being a provider at an urgent care unit has helped Prince be a better nurse, she said.
“Being out there as a civilian provider has given me the ability to offer guidance on what’s going on in the civilian health care world and participate in planning sessions,” said Prince, adding that the leadership role has exposed her to parts of the Air Force that she hadn’t previously experienced. “The education and professionalism the Reserve offers is amazing.”
Lt. Col. Katrina Lloyd, a civilian nurse practitioner and deputy state surgeon for the Louisiana Army National Guard, said serving in the military for the past 30 years has given her a higher sense of purpose.
“It’s rewarding to see that most times what we do has an immediate, profound, and positive effect on the soldier and his or her forward progression in the military and in life,” said Lloyd, who served as a combat medic for 11 years before entering the Army Nurse Corps and National Guard.
In civilian life, she serves on the faculty for Northwestern State University’s School of Nursing, and works as a provider at an urgent care facility.
“Soldiers and patients will be taken care of to the best of our abilities regardless of the environment,” said Lloyd. “But it doesn’t get any better than doing it in a military uniform because we are responsible for protecting the lives of the warfighter.”
For those considering joining one of the Guard or Reserve components, flexibility is key, said Lloyd. Spending time away from a civilian clinical setting has been challenging, but the overall support and understanding of her civilian counterparts helped make it possible, she said.
“Truly, to know that I’m wearing the uniform and feel as though I contributed something along the way has been really rewarding,” said Prince. “I’ve been deployed several times and I’ve been able to do my part, as I think everybody should, to support our country and our troops.”
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Military Health System chief points to thousands of everyday heroes during DC dinner honoring military medicine by Military Health System Communications Office
Dr. David Smith, currently performing the duties of the assistant Secretary of Defense for Health Affairs, speaks during the Heroes of Military Medicine dinner in Washington, D.C., May 4, 2017.The event recognized members of the military who have distinguished themselves through excellence and selfless dedication to advancing military medicine and enhancing the lives and health of the nation’s wounded, ill, and injured service members, veterans, and civilians. Honorees represent their respective services as Heroes of Military Medicine. They include: Air Force Lt. Col Benjamin Mitchell, emergency medicine physician and flight surgeon with Air Force Special Operations Command (AFSOC), 720th Operations Support Squadron – Operating Location Delta in Birmingham, Alabama; Army Col. John Oh, a trauma critical care surgeon at the Walter Reed National Military Medical Center in Bethesda, Maryland; and Navy Lt. Cmdr. Tatana Olson, the Operational Psychology Department Head at the Naval Aerospace Medical Institute in Pensacola, Florida.
In addition, Medal of Honor recipient retired Army Staff Sgt. Ty Carter was presented the Ambassador Award, and Army Gen. Raymond Thomas, commander of the U.S. Special Operations Command (USSOCOM) headquartered at MacDill Air Force Base, Florida, received the Senior Leader Award (and was represented in person by his deputy commander, Marine Lt. Gen. Joseph Osterman).
While the awards honored a handful of individuals, Smith used the occasion to talk about the 165,000 members of the Military Health System, who, in their own ways, are heroes every day.
“In some cases, heroes risk their lives on the battlefield to preserve the lives of others,” said Smith. “In some cases a hero makes good on the heroism of those battlefield heroes by ensuring that our wounded service members, once evacuated from the battlefield, get the best care that trained hands and medical technology can offer.”
Smith added that a hero encourages others to seek help when dealing with the “searing experience of combat,” while heroes can also be leaders who create the culture that inspires every service member to look after and care for their fellow warfighter. He credited the Army, Navy, Air Force, Public Health Service, academic and research partners, and Department of Defense civilians for working together and building teams of medical professionals around the world.
“It takes all of us,” said Smith, adding that while people can’t tell what service a care provider represents in an operating room, they can tell how well-prepared those medical professionals are. “They are ready. Ready to save a life, deliver a baby, reassure an anxious parent, or provide the mental health counseling that many of us need.”
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The scoop on probiotic and prebiotic foods by Uniformed Services University Human Performance Resource Center Staff
Prebiotic foods include bananas, onions, garlic, leeks, asparagus, artichokes, and whole grains. (Courtesy photo)
Eating foods with probiotics and prebiotics might aid your digestion, so try to include them in your healthy-eating plan. Probiotics are live microorganisms (such as bacteria) similar to the healthy bacteria that live in your gastrointestinal (GI) tract. Prebiotics are natural, non-digestible food ingredients that promote the growth of “good” bacteria in your GI tract. Eating foods with prebiotics might improve your digestive health and enhance calcium absorption too.
Some research shows two strains – Lactobacillus and Bifidobacterium – seem to offer the greatest benefits. Both can be found in probiotic foods such as kefir, buttermilk, sauerkraut, olives, pickles, miso (a soybean product), kimchi, and some yogurts and cheeses. Eating these foods might help prevent diarrhea caused by antibiotics and infections. They also might provide relief from symptoms associated with constipation, colds, allergies, and irritable bowel syndrome.
Prebiotic foods include bananas, onions, garlic, leeks, asparagus, artichokes, and whole grains. Top your yogurt with bananas or add asparagus to your miso soup to boost the mutual benefits of prebiotics and probiotics.
Probiotics can be found in certain dietary supplements and some skin creams too. However, the jury’s still out on whether they’re safe for long-term use, especially for people who have been diagnosed with weakened immune systems. The U.S. Food and Drug Administration also hasn’t approved any health claims for probiotics, so check with your healthcare provider about possible risks and side effects.
The greatest benefits from eating foods with probiotics and prebiotics occur when they’re part of a diet that includes whole grains, fruits, vegetables, and low-fat sources of dairy and protein. For more information about probiotics, visit the National Center for Complementary and Integrative Health's web pageDisclaimer: Re-published content may have been edited for length and clarity. Read original post.
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The scoop on probiotic and prebiotic foods — published: Filed under: Diet, Nutrition, Probiotics
Eating foods with probiotics and prebiotics might aid your digestion, so try to include them in your healthy-eating plan. Probiotics are live microorganisms (such as bacteria) similar to the healthy bacteria that live in your gastrointestinal (GI) tract. Prebiotics are natural, non-digestible food ingredients that promote the growth of “good” bacteria in your GI tract. Eating foods with prebiotics might improve your digestive health and enhance calcium absorption too.Some research shows two strains—Lactobacillus and Bifidobacterium—seem to offer the greatest benefits. Both can be found in probiotic foods such as kefir, buttermilk, sauerkraut, olives, pickles, miso (a soybean product), kimchi, and some yogurts and cheeses. Eating these foods might help prevent diarrhea caused by antibiotics and infections. They also might provide relief from symptoms associated with constipation, colds, allergies, and irritable bowel syndrome.
Prebiotic foods include bananas, onions, garlic, leeks, asparagus, artichokes, and whole grains. Top your yogurt with bananas or add asparagus to your miso soup to boost the mutual benefits of prebiotics and probiotics.
Probiotics can be found in certain dietary supplements and some skin creams too. However, the jury’s still out on whether they’re safe for long-term use, especially for people who have been diagnosed with weakened immune systems. The U.S. Food and Drug Administration also hasn’t approved any health claims for probiotics, so check with your healthcare provider about possible risks and side effects.
The greatest benefits from eating foods with probiotics and prebiotics occur when they’re part of a diet that includes whole grains, fruits, vegetables, and low-fat sources of dairy and protein. For more information about probiotics, visit the National Center for Complementary and Integrative Health's web page.-------
VAOIG - Administrative Summary of Investigation Regarding Wait Times - West Virginia for Monday, 8 May 2017 from The Veterans Affairs Office of Inspector General (OIG) in Washington, D.C., United States
The Department of Veterans Affairs, Office of Inspector General (OIG), conducted extensive work related to allegations of wait time manipulation after the allegations at the Phoenix VA Health Care System in April 2014. Since that event and through fiscal year 2015, we have received numerous allegations related to wait time manipulation at VA facilities nationwide from veterans, VA employees, and Members of Congress that were investigated by OIG criminal investigators.
At this time, OIG has completed more than 100 criminal investigations related to wait times and provided information to VA’s Office of Accountability Review for appropriate action. It has always been our intention to release information regarding the findings of these investigations at a time when doing so would not impede any planned prosecutive or administrative action. As other administrative summaries of investigation are completed, we intend to post them to our website so that veterans and Congress have a complete picture of the work conducted in their state.
You may view and download these administrative summaries of investigation by clicking on the link to our webpage at www.va.gov/oig/publications/administrative-summaries-of-investigation.asp and selecting the appropriate state. The individual summary may also be accessed by selecting the weblink below.
VA OIG Administrative Summary of Investigation at the Beckley, West Virginia VA Medical Center (14-02890-169)
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This service is provided to you at no charge by Veterans Affairs Office of Inspector General (OIG).
Veterans Affairs Office of Inspector General (OIG)
801 I Street, NorthWest
Washington, D.C. 20536, United States
800-827-1000
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