Theodore's World: VA To Limit Surgeries At Some Hospitals

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May 08, 2010

VA To Limit Surgeries At Some Hospitals

VA to limit surgeries at some hospitals

ARMY Times

In a move that could force some veterans to travel farther for surgery or have their operations at nonveterans hospitals, VA officials are imposing a new grading system on its 112 in-patient treatment facilities that will rank their abilities to do complex, intermediate or standard procedures.

Beginning May 11, no elective surgery will be done at a VA medical center that exceeds the rating, said Dr. William Gunner, the VA’s director of surgery.

Emergency surgery still could be done if required, he said.

The facilities immediately affected will be the medical centers in Alexandria, La.; Beckley, W.Va.; Fayetteville, N.C.; Illiana, Ill.; and Spokane, Wash., all of which received the lowest ranking and have been performing surgeries now judged to be beyond their capabilities.

Gunner began briefing lawmakers about what he called the “surgery complexity initiative” on Thursday, but said in an interview that the grading system has been in use since March, when agreement was reached on how to judge the complexity of a procedure against the surgical capabilities of each medical center.

Grading for medical centers takes into consideration medical staffing, both for the operating room staff and surgical consultants who are available, plus equipment and diagnostic capabilities.

Of VA’s 112 in-patient surgical facilities, 66 have been approved for complex procedures and 33 for intermediate procedures.

Thirteen facilities are limited to standard procedures, Gunner said. A review of what procedures have been done in recent years at those facilities found that five of the 13 had done operations of greater complexity, he said.

The VA does about 357,000 surgical procedures a year, and only about 364 are above the complexity grade of the facility under the new scale, which means the impact on patients should be small.

VA officials promise to help with transportation of veterans who might have to travel farther for surgery.

Complex procedures are cardiac, brain and pancreas surgeries, according to VA officials. Intermediate procedures include colon resections, joint replacement and repairs of abdominal aortic aneurysms. Standard procedures include things like hernia repair, surgeries to the ear, nose and throat, and urologic operations.

Those needing elective surgery that is above the complexity approved for the facility will have the option of being transferred to the next closest VA location that is approved for the surgery or be sent to a nearby civilian facility at VA’s expense.

VA officials said medical center transportation officials will try to help a veteran who has been referred elsewhere.

The initiative is VA’s response to criticism of problems with surgical care at the medical center in Marion, Ill. The issues at that hospital, since resolved, involved physician credentialing, standards of care, peer review and quality management. A review ordered in September 2007 found problems at other VA medical centers as well.

VA officials stress they are not cutting services, but are instead trying to improve care by ensuring that a surgical program at a particular facility is qualified to do a procedure.


Wild Thing's comment..........

I pray our Vets and troops would get the best of care. I have heard stories of both, some getting great care and others that have had real horror stories.

....Thank you Jack for sending this to me.

Army Combat Engineers
Quang Tri & Chu Lai '68 -'69
United States Army

Jack's blog is Conservative Insurgent

Posted by Wild Thing at May 8, 2010 06:48 AM


The VA has been taking fantastic care of my father-in-law. We always hear the horror stories but never the ones of success.

Posted by: BobF at May 8, 2010 10:23 AM

I am satisfied with most of the care I have received at the VA. Back in the 70's I swore off VA hospitals, but I have seen marvelous improvement in the past 40 years. In the past eight years I have had several minor surgeries and the results and the care were top notch.

Posted by: TomR at May 8, 2010 10:41 AM

Why is it the ones who do the most have to sacrifice the most and get the least respect.

Posted by: Mark at May 8, 2010 03:39 PM

Like you Tom I'm not unhappy with the service I get either, I know it's rationed but so far I've never been treated with more courtesy anywhere, wait times can be somewhat long to get in but once in it's professional precision. I do have to go to Seattle for surgery but I can take a shuttle from the nearest VA hospital north of Ft.Lewis. Instead of ramping up for the boomers, some of which are vets, they are cutting back. Thank you very much Chrissie.

Posted by: Jack at May 8, 2010 06:12 PM

Democrats said heatlthcare "reform" wouldn't affect the VA. Democrats said the worries about ration, whatever the healthcare system the reformed, were unfounded. Somehow, I think they lied.

Posted by: Anonymous at May 9, 2010 12:15 AM