Another VA Medical Scandal: Patients exposed to HepB/C, HIV due to Dentists laziness

[Bateluer]

http://www.cnn.com/video/#/video/health/2011/02/10/nr.vets.hiv.exposure.cnn?hpt=C2

http://www.whiotv.com/news/26788140/detail.html

More than 500 local veterans may have been exposed to diseases like HIV and Hepatitis.

On Tuesday, officials at the Dayton VA Center said 535 veterans may have been exposed to infectious diseases during visits to the dental clinic over the past eighteen years.

A testing clinic has been set up on the grounds of the Dayton VA Center effective immediately.

According to officials with the Veteran's Association, one dentist, who has not been identified, did not follow proper sanitary procedures. The dentist allegedly failed to wash his hands or sterilize dental equipment between patients. That would put the patients at risk for possibly being infected with HIV or Hepatitis B or C.

The CNN video has some more details on the specifics of this guy's actions. Using the same tools and gloves on multiple patients, operating the lunchroom microwave while gloves, then going back to the patient, operating the elevator buttons with gloves the going back to the patient, etc.

Absolutely appalling. Sadly, this is pretty typical of not just VA care, but also active duty medical care. The CNN video makes note that this 'doctor' is still on the VA payroll too. For those in P&N that wonder why so many people oppose government medical care, this is why. I'm a veteran myself, and I've my own collection of horror stories from the medical facilities, as well as pretty much every other Airman I served with. Nothing close to this though, or the Walter Reed stuff from a few years back. BTW, the Walter Reed issues are still ongoing, they haven't been fixed.

This where you want your medical care to go?

 

[Hayabusa Rider]

That sucks. Anyone who deals with possible contagions has proper sanitary technique
beat into their heads. I can't imagine there aren't sterilized instruments prepackaged along with new gloves. It's not like he had to do anything but get and use them.

If there's a plus side to this potential exposure doesn't mean automatic transmission. Most likely everyone is OK, but even if so that doesn't excuse systematic disregard of basic dentistry practices.

 

[Phokus]

http://www.cnn.com/video/#/video/health/2011/02/10/nr.vets.hiv.exposure.cnn?hpt=C2

http://www.whiotv.com/news/26788140/detail.html



The CNN video has some more details on the specifics of this guy's actions. Using the same tools and gloves on multiple patients, operating the lunchroom microwave while gloves, then going back to the patient, operating the elevator buttons with gloves the going back to the patient, etc.

Absolutely appalling. Sadly, this is pretty typical of not just VA care, but also active duty medical care. The CNN video makes note that this 'doctor' is still on the VA payroll too. For those in P&N that wonder why so many people oppose government medical care, this is why. I'm a veteran myself, and I've my own collection of horror stories from the medical facilities, as well as pretty much every other Airman I served with. Nothing close to this though, or the Walter Reed stuff from a few years back. BTW, the Walter Reed issues are still ongoing, they haven't been fixed.

This where you want your medical care to go?

1) Walter Reed isn't VA

2) You take anecdotal evidence of 1 case and that's somehow supposed to mean something about the VA as a whole.

Let me show you how it's done:

http://www.businessweek.com/magazin...gy_technology+index+page_best+of+the+magazine

And while studies show that 3% to 8% of the nation's prescriptions are filled erroneously, the VA's prescription accuracy rate is greater than 99.997%, a level most hospitals only dream about. That's largely because the VA has by far the most advanced computerized medical-records system in the U.S. And for the past six years the VA has outranked private-sector hospitals on patient satisfaction in an annual consumer survey conducted by the National Quality Research Center at the University of Michigan. This keeps happening despite the fact that the VA spends an average of $5,000 per patient, vs. the national average of $6,300.

 

[Phokus]

http://www.cbsnews.com/8301-504763_162-20008821-10391704.html

http://www.cbsnews.com/stories/2010/06/24/national/main6614791.shtml

Private practice doctor kills 68 patients, gets convicted. Ban private medicine.

(this is why using anecdotes is bad)

 

[Phokus]

BTW, i fully expect Amused to come in here guns blazing about how VA care is horrible because he used the exact same Anecdotal tactic in my other VA thread a few years back and subsequently got smacked down by people who had their OWN anecdotal stories about how VA care was great.

 

[HumblePie]

BTW, i fully expect Amused to come in here guns blazing about how VA care is horrible because he used the exact same Anecdotal tactic in my other VA thread a few years back and subsequently got smacked down by people who had their OWN anecdotal stories about how VA care was great.

LOL, I think I was the one that shot back at him with anecdotal stories

 

[Phokus]

LOL, I think I was the one that shot back at him with anecdotal stories

Heh, there were 2 or 3 people who shot back at him, that's for sure.

 

[Throckmorton]

This is exactly why I don't trust dentists on Maui. The consequences of incompetent medical care are a lot more serious than a simple sickness or injury. Getting HIV from the dentist... think about it. One trip to the dentist and the rest of your life is altered. Even if you didn't get HIV, you can't know until 6 months after exposure if you have been infected.

I'd rather hold off until I go back to Texas and can get care from my sister-in-law who is a germophobe.

 

[Bateluer]

1) Walter Reed isn't VA

Walter Reed is active duty, serving currently serving military members, which actually makes their abuse even worse. And its still a festering hole.

Judging by what I saw at Wilford hall on Lackland AFB and what I saw of the Luke AFB Medical Center, Walter Reed is the exception. These medical facilities are still regulated by the AMA, however, there's a lot of shielding the military physicians have. I've had to pay 4500+ out of pocket to fix damage done to my teeth by Luke AFB dentists, so this story really hits home.

As for the VA Medical Facility in Phoenix, where I live, I have no idea if their decent or not. They don't answer their phone or return messages. That might be evidence in itself. During my active service, we couldn't make appointments at the dental office or medical center. In order to be 'seen', you had to either A) call at 5am when they opened their doors to see if they could see you that day or B) show up for Sick Call, wait 8-12 hours, have a doctor tell you 'Yep, you're sick, go back to work and pop some OTC meds.'

In contrast, when I call my civilian dentist office, the phone is answered by a polite receptionist who listens to me, takes an appointment down. When I arrive, I sign in, and get seen with 5 minutes of my appt time. My Orthodontists office is even better.

Only had to use an HMO's services once though, so I can't comment much there. Little personal experience.

But, since Phokus obviously has no military or VA experience, its best to just disregard anything he posts.

Its not just government medical services that are atrocious either. I've got a book of horror stories about the Thrift Savings Program, tsp.gov, too. Shitbags are currently holding about 8k of my money, don't answer their phones, don't respond to emails, and take about 8 weeks to respond to snail mail.

 

[Phokus]

Walter Reed is active duty, serving currently serving military members, which actually makes their abuse even worse. And its still a festering hole.

Judging by what I saw at Wilford hall on Lackland AFB and what I saw of the Luke AFB Medical Center, Walter Reed is the exception. These medical facilities are still regulated by the AMA, however, there's a lot of shielding the military physicians have. I've had to pay 4500+ out of pocket to fix damage done to my teeth by Luke AFB dentists, so this story really hits home.

As for the VA Medical Facility in Phoenix, where I live, I have no idea if their decent or not. They don't answer their phone or return messages. That might be evidence in itself. During my active service, we couldn't make appointments at the dental office or medical center. In order to be 'seen', you had to either A) call at 5am when they opened their doors to see if they could see you that day or B) show up for Sick Call, wait 8-12 hours, have a doctor tell you 'Yep, you're sick, go back to work and pop some OTC meds.'

In contrast, when I call my civilian dentist office, the phone is answered by a polite receptionist who listens to me, takes an appointment down. When I arrive, I sign in, and get seen with 5 minutes of my appt time. My Orthodontists office is even better.

Only had to use an HMO's services once though, so I can't comment much there. Little personal experience.

But, since Phokus obviously has no military or VA experience, its best to just disregard anything he posts.

Its not just government medical services that are atrocious either. I've got a book of horror stories about the Thrift Savings Program, tsp.gov, too. Shitbags are currently holding about 8k of my money, don't answer their phones, don't respond to emails, and take about 8 weeks to respond to snail mail.

Lol, you could've have had the worst fucking experience at the VA out of every single veteran who has ever been to one and that wouldn't make a lick of difference because the VA has some of the highest patient satisfaction rates in the country. You pointing out that i'm 'not a vet' also doesn't make a lick of difference because, as in another thread i posted about the VA a few years back, there are vets and people related to vets who will cancel out your own anecdotal stories.

And for the past six years the VA has outranked private-sector hospitals on patient satisfaction in an annual consumer survey conducted by the National Quality Research Center at the University of Michigan. This keeps happening despite the fact that the VA spends an average of $5,000 per patient, vs. the national average of $6,300.

You know, broad surveys. A bit more scientific than one disgruntled vet bitching about his care.

Tell you what. Get rid of the VA. Lets give you vouchers to purchase private insurance instead Despite the fact that vets have combat wounds and are coming back with sicknesses from exposure to chemicals from wars in vietnam and iraq, no private insurer would be sane enough to ever want to insure those vets, especially at advanced age. So go ahead, be an asshole to your fellow brother veterans and fight to get rid of the VA.

 

[Amused]

Not the first time it's happened.

http://www.fiercehealthcare.com/sto...hiv-due-va-hospital-cleaning-gaffe/2010-06-30

More than 1,800 veterans at risk for HIV due to VA hospital cleaning gaffe

June 30, 2010 — 1:15pm ET | By Dan Bowman


Improperly washed dental equipment may have led more than 1,800 veterans being exposed to the hepatitis B and C viruses, as well as the human immunodeficiency virus (HIV) infection at the John Cochran Veterans Administration Hospital in St. Louis, according to a letter sent by the Department of Veterans Affairs to the vets on June 28.

Techs at the hospital washed the dental equipment by hand prior to putting the tools through a sterilization process, but protocol requires the equipment to go directly to the hospital's sanitizing and sterilizing department for specialized cleaning, reports KSDK.com. Dr. Stephen Streed, system director for epidemiology and infection prevention at HealthPark Medical Center in Fort Myers, Fla., and a member of the board of directors for the Association for Professionals in Infection Control (APIC), told FierceHealthcare that while the techs may have thought they were doing the right thing, cleaning and sterilization can be a much more complex process.

"Hand washing [equipment] may or may not remove all of the protein material, blood, serum and debris that's left on the instruments," Streed said. "Normally, you take instruments once they're used, and you send them through a series of enzymatic cleaning processes that sometimes use ultrasound and enzymes combined together; that both shakes the debris off and dissolves it off."

In its letter, the hospital urges veterans to get a free blood test as soon as possible, despite a "low risk of exposure."

"We deeply regret that this situation occurred," the letter reads, "and we assure you that we are taking all the necessary steps to make certain that testing is offered quickly and results communicated timely."

Rep. Russ Carnahan (D-St. Louis) called the situation "absolutely unacceptable" in a letter sent to Secretary of Veterans Affairs Eric Shinseki, and called for those responsible to be disciplined.

"No veteran who has served and risked their life for this great Nation should have to worry about their personal safety when receiving much needed healthcare services from a Veterans Administration hospital," Carnahan writes. "The men and women who have served this nation deserve the very best healthcare available--anything less is intolerable."

This is not the first time the VA has had to deal with an issue of this magnitude. Just last year, three patients who were patients at VA hospitals in Tennessee, Georgia and Florida respectively, all tested positive for HIV after exposure to contaminated equipment, with thousands more requiring testing. What's more, this is not the first time that this specific hospital has been cited for poor infection control: In 2008, the VA determined in a review of the St. Louis hospital that storage areas at the facility contained both clean linens and dirty patient care equipment, and that medications were stored at temperatures warmer than recommended. The review also noted that employees at the hospital failed to "consistently document actions when refrigerator temperatures were out of range."

"I think one of the most important things is to make sure that each organization, such as a hospital, has a sufficient number of infection preventionists who are specially trained experts in this area," Streed said. "[They need to be] both resourced and given the appropriate authority to make sure they can implement change when necessary."



I could post many more stories like this.

Like this one:

http://www.nursinghomesabuseblog.co...provides-inadequate-medical-nursing-services/

Or even better, this:

http://www.veteranstoday.com/2009/0...ent-of-veterans-affairs-under-the-microscope/

Systemic Problems at the Department of Veterans Affairs under the Microscope
June 20, 2009 posted by Robert L. Hanafin · 7 Comments
Several decades of systemic failures at Department of Veterans Affairs Medical Centers once again took center stage in Congress as the media (CNN) exposed several VAMCs in the Southeast that placed Veterans in several states at risk. This is a follow up on Veterans Today General Manager John Allen’s posting on VA Addresses Failures of Contaminated Equipment Use

John mentioned in his report that the concerns of the Chairman of the Subcommittee on Oversight and Investigations, House Veterans Affairs Committee shared by a Congressman from Florida focused on issues of responsibility, accountability, and credibility of the VA systems. Most significantly they focused on the systemic problems infecting the Department of Veterans Affairs.

John left us with a link to the proceeding that includes a webcam of what Congressional reps asked and the panel composed mostly of VA senior managers and medical personnel had to say. I received a phone call from a former VA employee who attended this meeting as a public observer. The feedback I got was that professional medical personnel tend to blame the systemic problems on mismanagement of administrative personnel at higher levels within VA upper and middle management. In sum, finger pointing. This inspired me to do another multi-part expose on what really transpired at this hearing and others in the future in laymen’s terms that any one like me with a high school GED can understand and relate to.


Veterans and military families under pressure, stress, and distrust of the Department of Veterans Affairs are not going to make or take the time to look up or read Congressional testimony unless it is spoon fed to them. We just don’t have the time or motivation.
I kick off the first part with opening statements made by the Chairman and Representative from Florida and by stating that the systemic problems running rampant in the VA practically makes the optimism of politicians and others who do not use the VA unrealistic. As you shall see first the members of Congress beat up on the VA representatives as well they should then end it with expectations that a slap on the wrist will change anything.

Ladies and Gentlemen, members of Congress, I’m among those here to tell you that nothing is going to change systemic problems that have existed for decades until VA upper and middle management regardless if medical or administrative personnel are disciplined for such failures to follow the VA’s own directives and policies. The employees, especially the upper and middle managers who supposedly set an example for the rank and file should be held to the same standards of responsibility and accountability as if they worked in the Pentagon or served in the Armed Forces where over delegating authority, responsibility, and accountability will get senior managers, military officers, and NCOs not promoted at best or fired at worse.

Last Tuesday, June 16, the House Committee on Veterans’ Affairs, Subcommittee on Oversight and Investigations held a hearing in response to media attention and public outcry about ,Endoscopy Procedures at the U.S. Department of Veterans Affairs: What Happened, What Has Changed? I believe by what has changed if anything really means what corrective actions the VA plans on making or promises to make in order to correct their image and regain the confidence of Veterans across the nation who will be very reluctant to get an endoscopy screening at any VAMC due to the risks involved. In laymen’s terms nothing has changed until VA upper and middle management’s forced to follow their own directives. Congressional representative setting nothing but expectations from the Department of Veterans Affairs have the authority, but lack the determination necessary to back up or enforce what they expect from VA.

As VA panel members, and every panel member was an apologists for the VA systemic problems not an impartial observer or two or three Veterans Advocates. These panel members represent the Department of Veterans Affairs not the Department of Veterans Advocacy. Without a disciplinary stick or punishment for incompetence, Congress forfeits this to medical malpractice and VA Claims attorneys that will result in the VA budget being far more than it ever has to be, and more money going toward legal litigation than treating America’s Veterans.

In his opening statement, Arizona Democrat Congressman Harry E. Mitchell, Chairman, Subcommittee on Oversight and Investigations noted just how systemic the problems of the DVA have been for decades, "We have been here before, and time and again, we have seen the VA violate the trust of those who have bravely served this country. The endoscopy issues in Murfreesboro, Augusta, and Miami are yet another reason for veterans to lose confidence in a system they rely on for the care we owe them."


Of course, there are people here who gave never served nor are vets nor have ever set foot in a VA facility who will try and tell us there aren't any problems.

 

[Phokus]

Not the first time it's happened.

http://www.fiercehealthcare.com/sto...hiv-due-va-hospital-cleaning-gaffe/2010-06-30

More than 1,800 veterans at risk for HIV due to VA hospital cleaning gaffe

.

http://www.cbsnews.com/8301-504763_162-20008821-10391704.html

http://www.cbsnews.com/stories/2010/06/24/national/main6614791.shtml

Private practice doctor kills 68 patients, gets convicted. Ban private medicine.

(this is why using anecdotes is bad)

68 Actual deaths from 1 private doctor. Again, based on your arguments, ban private medicine. Again, broad based surveys and studies > your isolated incidents.

Of course, there are people here who gave never served nor are vets nor have ever set foot in a VA facility who will try and tell us there aren't any problems.

Speaking of people who have never served, i find it interesting that the vets who DO serve who refute you... well, lets just say you ignore them.

Funny how that works. Also, what's funny is how nobody said there were every NO problems at VA hospital (just like you can't say that there are NEVER problems at private ones as well).

 

[Phokus]

LOL, I think I was the one that shot back at him with anecdotal stories

Here we go again

 

[Phokus]

Here you go amused, a similar story at a non-va hospital. CLEARLY, it's the fact that the VA hospital is a government owned hospital that's at fault and it possibly can't be, oh, i don't know, human error or human indifference.


http://www.allbusiness.com/medicine...rders-liver-disease-hepatitis/13147685-1.html

Oct. 7--Fort Lauderdale Police are investigating a veteran registered nurse who her employers say knowingly violated infection control procedures at Broward General Medical Center, potentially exposing more than 1,800 patients to blood-borne diseases such as HIV, and hepatitis B and C.

Police spokesman Sgt. Frank Sousa said the hospital asked for an investigation of Qui Lan, 59, who Broward General officials last month discovered was reusing catheter tubing and saline bags designed for one-time patient use during cardiac chemical stress tests. No charges have been filed and, as of Tuesday, police had not identified any victims, Sousa said.

Officials said it isn't known whether Lan -- whom neighbors described as kind and who hospital spokesmen said had no discipline problems -- deliberately put patients at risk and, if so, why.

Hospital investigators, who questioned Lan after an anonymous report tipped them to her alleged actions, said the nurse told them she was aware she shouldn't reuse the supplies, which deliver a saline solution intravenously to keep veins open during the stress test.

"But we still don't know why she chose to do this," Alice Taylor, chief operating officer of Broward General Medical Center, said Tuesday. "This is flagrant disregard of basic nursing principles."

Hospital officials are contacting 1,851 people identified as being potentially exposed since 2004, and are asking them to go for a blood screening at the hospital's expense. Infectious disease specialists, including experts from the Centers for Disease Control and Prevention, say the transmission risk is low; the reused equipment did not come in direct contact with the patients.

Officials with the Agency for Health Care Administration, which regulates hospitals in Florida, said the department conducted an on-site investigation and is finalizing a report.

Experts in infection control say they are alarmed by increasing numbers of illnesses contracted in medical settings due to health care workers not following basic practices, although no statistics are available. Earlier this year, the Department of Veterans Affairs hospitals in Miami and two other cities were discovered to be using nonsterile equipment for colonoscopies, with about 50 veterans later testing positive for blood-borne diseases.

The cardiac chemical stress tests that Lan administered don't involve running on a treadmill and, as such, sometimes are used for elderly or disabled patients, said Dr. David Droller, medical director of Broward General. Patients are injected with a chemical that causes the heart to speed up, mimicking what happens during exercise on a treadmill.

During the procedure, a nurse inserts an IV line into a patient's hand or arm, then connects the line to a bag of saline solution through a short and a long length of tubing. The IV line and the short piece of tubing directly connected to it were not reused by Lan, but the longer length of tubing and the bag were.

Droller said infections could occur only if blood pushed past clamps designed to prevent back flow into the tubing and bags, and those supplies were then later used on other patients.

Neighbors in Lan's upper-class Harbor Beach neighborhood in Fort Lauderdale declined to comment Tuesday. But Tomasz Vabrowski, who is housesitting for a next-door neighbor, said Lan visited him several times two years ago when he was hospitalized for a heart condition at Broward General.

He said he didn't believe Lan would intentionally do something to risk patients' health. "She's a very nice girl," said Vabrowski, whose wife works for Lan's neighbor.

Lan, who state documents show has an active Florida nursing license and an unblemished record, was suspended Sept. 8 and resigned a day later, Taylor said.

The hospital reported her to the Florida Board of Nursing. Police believe Lan now is out of the country.

James Thaw, CEO of Broward Center, said the hospital waited a month to contact police, while staff concentrated on notifying patients and arranging for them to have their blood tested at an off-site laboratory.

More than 700 people on Tuesday called a special medical center hotline, as certified letters describing the infection protocol breach began landing in the mailboxes of the 1,851 at-risk patients Lan saw between January 2004 and last month. Another 40 came to see counselors stationed in the hospital's second-floor auditorium.

"I'm going to be on pins and needles until the blood test comes back, and that's two weeks," said Betty Lauvier, a 45-year-old Pompano Beach woman who had the chemical stress test in January because she is an amputee.

For more information, go to browardhealth.org/patientnotice, or call 800-545-5716.

Staff Writer Rafael Olmeda and Staff Researcher Barbara Hijek contributed to this report.

Diane Lade can be reached at dlade@SunSentinel.com or 954-356-4295.

To see more of the Sun Sentinel or to subscribe to the newspaper, go to http://www.sun-sentinel.com/ . Copyright (c) 2009, Sun Sentinel, Fort Lauderdale, Fla. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com , call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.

 

[Amused]

Reading comprehension is hard, I know.

Several decades of systemic failures at Department of Veterans Affairs Medical Centers once again took center stage in Congress as the media (CNN) exposed several VAMCs in the Southeast that placed Veterans in several states at risk. This is a follow up on Veterans Today General Manager John Allen’s posting on VA Addresses Failures of Contaminated Equipment Use



"In his opening statement, Arizona Democrat Congressman Harry E. Mitchell, Chairman, Subcommittee on Oversight and Investigations noted just how systemic the problems of the DVA have been for decades, "We have been here before, and time and again, we have seen the VA violate the trust of those who have bravely served this country. The endoscopy issues in Murfreesboro, Augusta, and Miami are yet another reason for veterans to lose confidence in a system they rely on for the care we owe them."

 

[Phokus]

Reading comprehension is hard, I know.

Oh really? So when the VA has a 99.997% prescription accuracy rate while all other hospitals outside of the VA only have a 93 to 97% accuracy rate, is that systemic?

Or how about 48,000 deaths from hospital infections each year?

http://www.webmd.com/healthy-aging/news/20100222/hospital-infections-kill-48000-each-year

Is that systemic?

Or how about the VA beating out private hospitals in patient satisfaction and also costing less per patient, even though vets are typically sicker than the general population?

Is that systemic?

Post facts, not rhetoric from someone who's trying to get re-elected.

 

[Phokus]

CBO Report

http://www.cbo.gov/ftpdocs/88xx/doc8892/MainText.3.1.shtml#1070090

Tell me Amused/Bateleur, how come the overwhelming majority of vets approve of the care they get from the VA and their approval is higher than private care?

Evidence of the Quality of VA’s Health Care
VA officials have often cited studies that have given the department high ratings for the quality of its medical care. For example, then-Secretary of Veterans Affairs James Nicholson stated in a speech in July 2007, "We lead private and Government health care providers in almost every measure and our state-of-the-art quality care arcs from the research lab to a patient’s bedside."7 Michael Kussman, then-Acting (now confirmed) Under Secretary for Health, gave testimony before the Congress in March 2007 in which he called VA "the Nation’s leader in providing high-quality health care" and cited a number of external research studies to support that claim.8

VA tracks the quality of its medical care using a variety of indicators for such areas as adherence to clinical guidelines, waiting times for access to services, and customer satisfaction. One key index is the Clinical Practice Guidelines Index, which measures the degree to which a provider follows nationally recognized standards of care that

have been shown to improve health outcomes.9 Another is the Prevention Index II, which VA uses to track compliance with clinical guidelines for preventive care that research has tied to improved health and well-being.10 In 2006, VA reported average scores of 87 percent on the Clinical Practice Guidelines Index and 90 percent on the Prevention Index II, exceeding the department’s targets of 77 percent and 88 percent, respectively.

11 For both measures, the scores have improved in recent years. From 2004, when the Clinical Practice Guidelines Index was put in place (replacing an older composite measure), to 2006, VA’s score on the index rose 10 percentage points. VA’s score on the Prevention Index II rose 8 percentage points from 2002 to 2006. CBO was unable to identify any directly comparable scores for other government providers or for private providers because, even though VA’s indicators are composed of many individual measures that are commonly used throughout the health care industry, the indexes are composites developed specifically for VA. In 2008, VA is planning to adopt more quality measures that are industrywide, such as those in the Healthcare Effectiveness Data and Information Set (HEDIS), in order to improve comparability with other providers.12

Those key indexes used by VA focus on process measures of quality rather than outcome measures for several reasons. First, process measures are easier to track—for example, VA’s electronic health information system can easily identify what percentage of heart patients had their blood pressure checked during their last primary care visit. Second, process measures are easier to compare among facilities; they do not need to be adjusted for differences in the risk of the population of patients. Third, the process measures that are tracked are drawn from published clinical guidelines, which in turn are based on published research regarding health outcomes for patients. Nevertheless, it is important to examine health outcomes in addition to process measures, as some process measures have been shown to have a relatively tenuous connection to health outcomes.13

Although some studies have compared outcomes for VA patients with those for patients treated by other providers, they have not allowed for drawing broad conclusions.14 In such studies, adjusting for differences in the risks of the patients can be problematic. Also, VA patients may have other sources of health coverage (such as Medicare, Medicaid, or private insurance) and often seek some care outside of VA’s system, complicating the distinction between a "VA patient" and a "non-VA patient." Thus, although it remains important to study the health outcomes of VA patients and to compare them to those for patients in other systems, VA is likely to continue to rely heavily on process measures in gauging and improving the quality of care in its facilities.

VA also tracks measures of access to care, particularly, waiting times for appointments or procedures. VA reported that, in 2006, 96 percent of all veterans seeking primary medical care and 95 percent of all veterans seeking specialty care were seen within 30 days of their desired dates.15 However, according to a 2005 report by the VA Inspector General (IG), the department’s data on waiting times were not accurate, and, in fact, many fewer patients were receiving appointments within the 30-day window than the figures cited by the department in its official reports.16 In September 2007, in a follow-up audit, the VA IG found that established procedures were still not being followed and that, as a result, data on waiting times could not be relied upon.17

In addition to measuring quality and access, VA also tracks its performance in terms of patients’ satisfaction, including using the American Customer Satisfaction Index (ACSI), which ranks customer satisfaction with a variety of federal programs and private-sector industries.18 In 2005, VA achieved a satisfaction score of 83 (out of 100) on the ACSI for inpatient care and 80 (out of 100) for outpatient care, compared with averages for private-sector providers of 73 for inpatient care and 75 for outpatient care. In 2004, the ratings were higher for both VA and the private sector. For VA, the scores for inpatient and outpatient care were 84 and 83, respectively, while the average scores for the private sector were 79 and 81.19 Starting in 2008, VA hopes to track its patients’ satisfaction using the Consumer Assessment of Healthcare Providers and Systems (CAHPS), a set of standardized surveys developed by the Agency for Healthcare Research and Quality (AHRQ) that ask patients to evaluate their health care experiences. Using the CAHPS surveys could improve VA’s ability to compare its performance to that of the Department of Defense and the private sector.

One potential concern about assessing the satisfaction of VA’s patients is the impact that the department’s low cost-sharing requirements may have on the ratings. Patients with service-connected disabilities receive care for those conditions free of charge. For the treatment of conditions not connected to service, VA may charge low copayments and can also bill veterans’ private insurance plans. The copayments for prescription drugs, outpatient visits, and inpatient care are relatively modest when compared with those faced by most users of private-sector health insurance. It is possible that individuals who face low or no costs for their care may be more satisfied than those who pay higher costs. However, it is also possible that veterans have high expectations of the level of service they should receive from VA’s health system as individuals who served their country in uniform, sometimes incurring disabilities in the process.

Another potential concern about how to interpret VA’s satisfaction ratings is the fact that the ratings do not incorporate the satisfaction of veterans who cannot access the system (either because they are priority group 8 veterans who were not enrolled before the January 2003 freeze in enrollment for that group or because VA facilities are geographically inaccessible to them) or who choose not to use the system. However, for any health care system, satisfaction ratings reflect the views only of people who are patients within that system.

VA is not alone among government health care providers in tracking patients’ satisfaction. In recent years, the Department of Defense’s TRICARE system has increasingly emphasized improving its beneficiaries’ satisfaction (see Box 4). Although TRICARE’s overall satisfaction ratings compare favorably to civilian benchmarks, active-duty service members, who generally must use the in-house military health system, report lower satisfaction than do family members and retirees, who have better access to the civilian TRICARE network. Retirees report slightly higher levels of satisfaction with the system than active-duty personnel and their families do, despite the fact that retirees generally pay higher cost-sharing amounts.

 

[Craig234]

LOL, I checked the thread to see whether the OP reported the story accurately, or tried to fallaciously argue it somehow proved 'government medical care is bad!!'

I was right to suspect him for his ideological spewing.

Yes, a Dentist did bad. Let's get rid of the VA and all government healthcare, it's all proven more harm than good now. The private system could never have this happen.

And for good measure, let's SCREAM for slashing government spending, things like 'across the board cuts' and demanding the VA give the best care on less money.

Ah, yes, the Republicans are so good at government.

Read Thomas Franks' "The Wrecking Crew" for more hilarious Republican stories.

In fact - based on this principle that a bad dentist means shut down government healthcare - can we ban Republicans from voting or holding power?

 

[OutHouse]

A) call at 5am when they opened their doors to see if they could see you that day or B) show up for Sick Call, wait 8-12 hours, have a doctor tell you 'Yep, you're sick, go back to work and pop some OTC meds.'

QFTMFT!!! there were a couple of times when i woke up feeling like a truck hit me. My shift started at 6am and sick call started after i was to be on duty so i had to go to the ER. Both times i could tell the "doctor" was pissed at me because i woke him from his sleep. both times i was sent to duty with 102 temp and wracked with chills and a bottle of 800mg Motrin. Meanwhile i had a female Lt who went in several times for a fricken cold and got 5 days excused from duty. god that shit pissed me off.

my last experience with a military hospital was when i was getting out. I had like 3 days left so i was already released from my flight. so i was at my residence (on base housing) packing. I got a pickup bed turned into a trailer and was hitching up to my truck. well like a dummy i had my hand around the front of the hitch and was looking at the trailer not realizing how close i was to my bumper. the trailer got away from me and smashed my fingers between the lip of the hitch and my bumper. i thought my ring finger was broken, i felt it snap and had a cut down to the bone. so my wife drives me to the base ER and i go up to the counter and show them my now swollen and bleeding hand. some piece of shit crusty senior master sergeant too scared to retire tells me to have a seat and hands me a towel for my blood loss. 1 hour later they call my name and ask me where my medical records are and i told them personnel has them because iam 3 days from getting out. They reused to see me because i did not have my fucking medical records!!! I call up my first sergeant and told him what was going on, he and my capt come down to the ER and raise holy hell and i finally saw a damn doctor, got x-rayed. no broken finger, no stitches because it had already been 2 hours and the bleeding stopped, just a butterfly band-aid and have a nice day. i still have the scar.

Grand Forks Air Force Base. 5.5 years in that hellhole and i swear on my grave im never going to north dakota again.

Oh and let me tell you about my lovely first military hospital experience while going through Tech School. I woke up on a saturday morning sick as a dog. i had to grab the trash can to puke in. my two roomies woke up an weren't too happy but hey i didn't yack all over the floor. as the morning ticked away i got worse. i was puking every 20 min so we call up a shuttle to take me from the dorm to the dispensary. once there i check in and tell them whats wrong with me. "have a seat airman" ok.... i keep getting worse, now im puking every 10 min, i swear it was to the second. so im going from the waiting room to the bathroom and back. they finally call my name and tell me to go to room 4. out side of room 4 are chairs and there are two airman seated ahead of me and who are clearly in basic training and probably wanting homesick pill. well im still puking and when i get back some other POS basic trainee is in my chair. im too sick to argue so i sit down and sure enough 10 min later its time to yack again. i tell the guy, "hey i have to puke, do not let anybody take my seat" he says ok. When i get back from heaving some jack ass is in my chair!!!

that's it, i need to be seen now. so i walk in on the doctor and when he looks up at me i tell him i need to see him now. well he didnt take too kindly to that and tells me to go sit back out in the hall. I explained to him i have been out there for 45 min and when i get back from dry heaving some dude took my spot. he gets up walks over to me i guess to get in my face but i guess he saw i was not fucking around and kicked the home sick baby out and had me get on the table. good thing too because it was time to hurl again. does a exam and calls orderly's to come get me. they took me to what looked like a ER/OR. i get out of the wheelchair and lay on the table. by now its like 2pm and im still puking every 10 min. they gave me a shot to stop it. nope didnt work so they gave me another, that helped but knocked my ass out. next thing i now im in an ambulance getting transported to wilford hall (think Walter Reed but air force). they wheel me into the waiting room and parked me against the wall. the place was packed with military and retirees. i was parked there pm the gurney for 2 solid hours before anybody came for me. i just turned and faced the wall and when it was time to puke i would wake up, yack in the little puke tray and fall back to sleep.

when the nurse finally came to get me i was in bad shape and i had to piss so bad it took all my reserve energy not to let go when they wheeled me to the exam room. it told them i had to pee like no other and they said the bathroom is right there. good thing the nurse was there because when i tried to stand she had to catch me. so she gave me a choice she could help me "potty" or she can put a tube up my penis. i chose option 1. Next the doc wanted a blood sample. i was so dehydrated they could not get a vein, so they went to the extreme and found a vein on my damn foot. you want to talk about hurt, just imagine a fucking needle sliding into a vein between your big and middle toe.

i spent a 8 days in wilford hall and went through 18 bags of fluids. never found out what was wrong with me but yea i do not want an experience like that again.

 

[OutHouse]

Tell me Amused/Bateleur, how come the overwhelming majority of vets approve of the care they get from the VA and their approval is higher than private care?

**Personal observation and opinion***
a lot of them bleed military plus many of them dont know any different because all they have been to are military medical facilities.

 

[Phokus]

**Personal observation and opinion***
a lot of them bleed military plus many of them dont know any different because all they have been to are military medical facilities.

At least you prefaced that correctly, unlike SOME people in this thread.

I have a hard time believing that a group of people with a fairly rightwing bent would somehow have a bias in favor of a truly socialized healthcare system (even more so than Medicare or Canada's healthcare which is still private healthcare delivery but a public insurance system).

On the other side of the equation, you have private healthcare delivery, but conservatives prefer that to socialized systems (of course), and even liberals don't object (they just want public health insurance, a system like medicare or canada's).

Problem with the VA is that it's a very large system. If there was a problem, it's going to be public, and conservatives/politicians/media are going to be screaming at the top of their lungs about the WHOLE VA system. With a private healthcare system, if you have a hospital that fucks up, it might only be a part of a small private healthcare system of 3 hospitals, for example. It might make the news, but the private system doesn't get painted with the whole brush, even though private healthcare might have a systemic problem as a whole.

For example, in ATOT, there's a thread about a woman who was accidentally prescribed an abortion pill by a privately owned pharmacy and she had to go to a hospital because of it:

http://forums.anandtech.com/showthread.php?t=2141887&highlight=abortion

You don't hear people clamoring to socialize that aspect of the healthcare system, even though, statistically prescription mistakes are exponentially higher in a private system (3%-8% error rate) than in the VA system (.003% error rate). That's 1000 to 2666 times the error rate for the private system. So the woman accidentally an abortion pill or someone getting the wrong pill that interacts with other meds and harms them would be more common in a private system, it's not just an anecdotal story.

The problem with anecdotal stories is that there's a self selection and confirmation bias (especially with someone like Amused) that goes into, plus the fact that it's completely unscientific to take isolated incidents and somehow draw conclusions from that.

 

[Doc Savage Fan]

Meanwhile...systemic issues persist in St. Louis...how nice.
http://www.stlamerican.com/news/local_news/article_c2c83af8-30a7-11e0-96a7-001cc4c002e0.html
VA Halts Surgeries at St. Louis Hospital

February 04, 2011
Associated Press

ST. LOUIS - The VA Medical Center in St. Louis halted surgeries indefinitely this week after a regular inspection showed possible contamination of equipment, the hospital's medical director said Thursday.

RimaAnn O. Nelson said spots were noticed on surgical trays and water stains on at least one surgical instrument before any surgeries were performed Wednesday. She said hospital officials have since inspected all other surgical materials and had vendors at the center Thursday inspecting and testing all surgery-related equipment.
Nelson did not say how many patients might be affected or when surgeries might resume.

"VA will work with all affected veterans to reschedule surgical appointments or arrange for alternate care in any urgent cases," Nelson said in a statement.

The episode is the latest case of sterilization problems at the John Cochran VA Medical Center.

Last year, the VA notified 1,812 veterans who were treated at the center's dental clinic from Feb. 1, 2009, through March 11, 2010, that they might have been exposed to HIV, hepatitis B and hepatitis C because of improperly sterilized dental equipment. They were urged to be tested for the diseases.

The VA announced in July that of 1,022 veterans who were tested and told of the results following the alert, two tested positive for hepatitis B and two for hepatitis C. The agency later said no known cases of disease were linked to the sterilization problem.

St. Louis VA medical facilities provide services for veterans in Missouri and Illinois. The U.S. House Committee on Veterans Affairs held hearings on the situation at the St. Louis center in July.

U.S. Rep. Russ Carnahan, a Democrat from St. Louis who announced his appointment to the committee Thursday, has been especially critical of the medical center's response to the contamination problems.

"How many times does something have to happen before they fix this facility?" Carnahan said in a statement. "Clearly the problems there go well beyond one department. It's time for a full, top-to-bottom, independent review of the entire facility. It needs to happen and it needs to happen now. The health and safety of our veterans is too important to wait."

In 2009, the Department of Veterans Affairs notified about 10,000 veterans who were treated at VA hospitals in Augusta, Ga., Miami and Murfreesboro, Tenn., that they may have been exposed to infections during colonoscopies or other endoscopic procedures where equipment had been improperly cleaned.

More than 50 subsequently tested positive for infections - including at least eight who tested positive for HIV. The VA said at the time it was impossible to tell where those infections came from, but it is offered free medical treatment to all those affected.

In a follow-up, the VA's inspector general reported in September 2009 that the department's medical facilities had made significant progress on fixing endoscopic procedure problems. The report said surprise visits to 128 medical facilities found all of them compliant in following procedures.

 

[Phokus]

However, at least the VA self polices their facilities.

In a follow-up, the VA's inspector general reported in September 2009 that the department's medical facilities had made significant progress on fixing endoscopic procedure problems. The report said surprise visits to 128 medical facilities found all of them compliant in following procedures.

 

[Darwin333]

Lol, you could've have had the worst fucking experience at the VA out of every single veteran who has ever been to one and that wouldn't make a lick of difference because the VA has some of the highest patient satisfaction rates in the country. You pointing out that i'm 'not a vet' also doesn't make a lick of difference because, as in another thread i posted about the VA a few years back, there are vets and people related to vets who will cancel out your own anecdotal stories.



You know, broad surveys. A bit more scientific than one disgruntled vet bitching about his care.

Tell you what. Get rid of the VA. Lets give you vouchers to purchase private insurance instead Despite the fact that vets have combat wounds and are coming back with sicknesses from exposure to chemicals from wars in vietnam and iraq, no private insurer would be sane enough to ever want to insure those vets, especially at advanced age. So go ahead, be an asshole to your fellow brother veterans and fight to get rid of the VA.

Personally I think that vets should have an "all exclusive" .gov insurance card that allows them to go to any hospital or doctor they want to within the US. Not sure how that would work overseas but I am friends with a vet who has to find someone to drive him 3 1/2 hours away and back twice a month. The irony is that one of the best possible places to treat his particular problem is a 10 minute drive from his house.

I am not really advocating getting rid of (or keeping for that matter) the VA hospitals, I just think they should be able to go wherever the hell they want.

 

[trenchfoot]

QFTMFT!!! there were a couple of times when i woke up feeling like a truck hit me. My shift started at 6am and sick call started after i was to be on duty so i had to go to the ER. Both times i could tell the "doctor" was pissed at me because i woke him from his sleep. both times i was sent to duty with 102 temp and wracked with chills and a bottle of 800mg Motrin. Meanwhile i had a female Lt who went in several times for a fricken cold and got 5 days excused from duty. god that shit pissed me off.

my last experience with a military hospital was when i was getting out.

*snip*

i spent a 8 days in wilford hall and went through 18 bags of fluids. never found out what was wrong with me but yea i do not want an experience like that again.

Sorry to hear of your experience, and just wanted to share mine under the heading of misery loves company, but this time for laughs:

So I get really really sick in Basic, go on sick call with a 102 fever. By the time I get diagnosed (they never ever told me what I was sick from) I'm doing 104. By the time I get into a bed I'm doing 105. So the remedy for that is I get ordered to start pumping myself with large doses of iced kool-aid (I have to get up out of bed, go out to the cafeteria down the hall and refill, piss on the way back, repeat-repeat-repeat). The fever doesn't go down, so now I get the joy of having ice packs between my legs and armpits. So now I have to refill my kool-aid, and refill my ice packs at the ice machine in the cafeteria every few hours, until on my way back to the room I collapse from the delerium of the high temps. I make a mess with the kool-aid soaking my gown and make a mess on the floor. An orderly comes rushing up to me literally screaming at me to clean up the mess while I'm still floating in Lake Kool-aid. So I push myself up to a sitting position, my palm slips in the kool-aid and my ear smacks into the cherry colored pond and I get this piercing pain in my ear like I know something broke in there, and all the time this orderly keeps yelling at me to get up and clean up my mess. BTW, this is all happening around 0200. A towel appears out of nowhere so I start sopping the mess up. A mop and pail then appears out of nowhere so I start using that. Somebody yanks the mop out of my hands and tells me to GTFO of THEIR hallway and never come back.

So I get back to the room with the other five-six guys in there, crawl back in bed and fell asleep. A few seconds later (3 hrs. - I know this because at 0600 it's time to get up, make up our beds and crawl back in again - IDKW) this pretty nurse starts yelling at me that I messed up HER bed from the kool-aid soaked gown and how the hell did I do that and where was HER ice bags and why did I have to ruin HER day like I did. All this while I'm still running a high fever. I knew that because every time I yawned the tears that welled up felt hot.

So I get to sponge bath myself, get a fresh gown (finally) and whoo-hoo fresh sheets (finally).

Spent six frolicking days in the hospital, got all kinds of people pissed at me just for being there, never was told what I was sick from and had to recycle two weeks back in Basic.

FUN!