LOL, look at the article about the hospital that was a former employer.

Pliablemoose

Lifer
Oct 11, 1999
25,195
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Dallas VA hospital is nation's worst

Officials say they've eliminated most problems in federal report

07:00 AM CST on Tuesday, January 18, 2005

By DOUG J. SWANSON / The Dallas Morning News

The Dallas veterans hospital is so dirty, dangerous and poorly managed, federal investigators have found, that it ranks as the worst such medical center in the country.

An inspector general's report for the Department of Veterans Affairs said the scores for the North Texas Health Care System place it last among all veterans facilities. The report assessed 80 percent of the system's performance indicators below the "fully satisfactory" level.

The flagship of the North Texas system is the Dallas VA Medical Center. Investigators there found that "most patient rooms and bathrooms we inspected were unclean." Also, floors and walls "had buildups of grime," and some stretchers displayed "dried residue suggestive of body fluids."

Those in charge "did not maintain a consistently clean and safe environment," the report said. And investigators found no evidence of a plan for better management.

The deadline for the system's formal written response to the inspector general is Wednesday. Hospital officials said they already have eliminated most of the problems identified in the report, which was released late last year.

"Frankly, that's the job of the I.G.," Dr. Robert Cronin, the system's chief of staff, said of the report. "They don't come and give you a pat on the back and say you're doing a great job.

"We got the message. We're working hard to correct those things. ... We've added a number of people to help us get the job done."

Alan G. Harper, who had been director of the VA's North Texas system for 14 years, left that position several weeks ago. Allen Clark, public affairs officer, said no conclusions should be drawn from the timing of the inspector general's report and Mr. Harper's departure.

"It was time for him to retire," Mr. Clark said.

Mr. Harper could not be reached for comment Monday.

The Dallas hospital complex covers 84 acres near Lancaster Road and Loop 12 in Oak Cliff. It is the center of a system that serves 38 counties in Texas and two in Oklahoma. Last year, the hospital had more than 13,000 admissions and almost 626,000 outpatient visits.

The system also operates an outpatient clinic in Fort Worth and a small hospital in Bonham.

Patient assessments

Some patients at the Dallas hospital last week gave it a range of reviews.

"It's the worst VA I've been in," said Joe Hillyard of Waxahachie. The 48-year-old Army veteran said he has been treated at five veterans hospitals for post-traumatic stress disorder.

He complained of long waits to see a doctor and delays in the filling of prescriptions at the Dallas medical center. "I was here at eight o'clock yesterday morning," he said. "I didn't get out of here until six o'clock in the evening."

But 80-year-old Jim Neatherlin of Paris, Texas, a patient since 1980, praised the hospital and its staff. "They always treated me real nice," he said.

And cancer patient Louis Powell, a 76-year-old Army veteran from Hurst, said he has high regard for the medical center. "They treat you real good, no problem," he said.

Report findings

The inspector general's report, however, cited a variety of shortcomings. Among them:

?There were unspecified deficiencies in a number of "high-risk processes," including medication management, restraint use, invasive procedures, resuscitation and mortality review.

?The system administration's quality management program "was not planned, systematic or coordinated." Managers did not "collect, trend or analyze mortality data."

?No one in management analyzed complaints collected by the hospital's patient advocate.

?"Not all patient injuries were recorded, and nurse managers did not receive reports relating to medication errors or falls."

?"Floors and walls had buildups of grime and the rooms had foul odors, suggesting they had not been thoroughly cleaned over a significant period."

?Intravenous pumps were dirty.

?Exposed electrical connections, such as uncovered heater switches, were found in patient bathrooms. Patients' refrigerators needed cleaning.

?In one unit, "the medication refrigerator temperature was consistently below the required range, possibly altering the effectiveness of the medications."

?Several crash carts ? portable cabinets containing life-saving equipment to use in case of cardiac arrest ? "were in disrepair and required tape to keep the doors closed."

?"An IV pole, soiled linen, a mop pail of dirty water, an oxygen tank and a biohazard can were inappropriately stored in the radiology dressing area. Radiology equipment was covered with thick dust."

?"We concluded there was no evidence of a planned, collaborative effort to improve organizational performance."

Dr. Cronin, the chief of staff, said inspectors "found more than we might have expected" but said improvements are under way.

"Frankly, we didn't pay enough attention to them," he said of the problems. "But we are now."

I told them to fvck off about 2 months ago, I couldn't stand the mismanagement & horrible conditions any longer & left for at least a cleaner hospital.

One of the assholes I got crossways with got canned last month, this is just too sweet.

Here's a link to the Office of Inspector General's report: PDF (it even has pictures)

Newspaper article

If you want to look, the bug me not code is:

noone99999@nowhere.com
123456

I'd bitched for years about stuff, the last few years, it was just about safety of the patients & staff, wrote my congressman, asked her to keep it quiet & the assholes gave the hospital my name etc, & of course the hospital made my life a living hell for trying to do something...

I've worked at 3 other VA hospitals & this one was the freaking worst I've ever seen or heard about.

This is just too sweet, almost wish I'd stayed to watch the fireworks, but it'll take years to fix everything & everyone will be running around pointing fingers & doing a circular firing squad.

UPDATE 1/25/05:

Another article in the paper today, someone I know is going to help with the next article...;)

Survey rips VA nurses

Medical students say Dallas hospital staff incompetent; chief says problems are 'isolated'

10:20 PM CST on Monday, January 24, 2005

By DOUG J. SWANSON / The Dallas Morning News

Medical students at the Dallas veterans hospital, which was recently ranked the worst in the nation, say its patients have been neglected, abused and sometimes left alone to die by incompetent and uncaring nurses.

"I would hate to be a patient under the care of any of the nurses at this institution," one student wrote in response to an annual survey by the U.S. Department of Veterans Affairs.

Another characterized the quality of nursing at the Dallas medical center as "reprehensible," adding: "Patients are sometimes left to survive on their own without appropriate care."

The hospital's chief of nursing said in response Monday that only a "few people" on her 850-member staff performed so poorly.

"We have some isolated problems," said Burlean Huff. "I believe this is not systemic."

Most of the comments came from University of Texas Southwestern Medical School students and residents who trained last year at the Dallas VA hospital. They described observing firsthand a hospital in which some nurses and support staff members show little interest in caring for patients, even those in critical need of attention.

"It's sad to see how our veterans are treated," one wrote.

Gail Bentley, the hospital's associate chief of staff for education, said management had not been aware of the concerns until receiving results of the survey last month.

"We were shocked," she said Monday, adding that officials are developing a "written plan of action."

She added: "We don't think this represents the care we give, but it's a perception. So we have to respond to the perception."

The Dallas Morning News reported last week that the Veterans Affairs inspector general ranked the Dallas hospital as the worst veterans medical center in the country.

Hospital officials insisted then that they had eliminated problems with sanitation and patient care cited in the inspector general's report. They also played down the severity of that report's findings.

"At no time were patients in any danger or receiving care that was substandard," said Thomas Stranova, regional director for veterans health care.

But the remarks of medical students, released to the Dallas hospital's nursing staff late last week, tell a different story.

"Many times I have had patients urgently sick and 'crumping' [about to die], and nurses will not care and say, 'I'm busy, do it yourself' when you ask them for help," one student wrote. "Overall, the nursing staff and ancillary staff are pitifully poor and extremely below the quality of a regular hospital. PLEASE CLEAN THIS PLACE UP!!!"

Another student told of critically ill veterans abandoned until dead.

The Dallas VA hospital, the student said, is a place "where nurses do not evaluate their patient during a whole shift and then call a CODE when the patient is already 'stiff,' stating that 'they had just been out of the room.' "

To call a code means the patient has suffered cardiac or respiratory arrest.

Nursing chief Huff said that because such remarks were anonymous and not dated, she could not confirm the accuracy of the accounts.

"I would be hard-pressed to believe this ... is true," she said. "Some of these comments, I would have thought that had it happened, we would have heard about them."

The survey, covering numerous aspects of medical training, was conducted by the national veterans Office of Academic Affiliations. It does so each year, via e-mail, with students at veterans hospitals.

From the Dallas medical center, 162 students participated in the survey in April and May. Their responses were sent to Dallas hospital officials in December.

Last week, nursing chief Huff passed the written comments regarding nursing care to her staff in an eight-page memorandum. The comments on nursing came from several dozen medical students and residents, she said.

An employee of the Dallas VA sent a copy of her memo to the News, which authenticated the document with hospital officials.

Other medical student observations included:

?"Medications were not given when requested. Blood draws were often not made."

?"Ward nurses in general were extremely lazy. ... If you asked for a wound dressing changed, you were more likely to have the nurse give you their house and first-born child rather than do this task."

?"I had times when I was completely appalled at the laziness and disregard for patient care evident in more than a few nursing employees. On more than one occasion, patients threatened to leave the hospital AMA [against medical advice] due to the rudeness of the nurse or blatant neglect."

?"There are some great nursing staff, but many would never make it in an outside facility from what I can discern."

?"I have encouraged members of my family who were in the armed forces to make sure that they have insurance so that they will not have to use the VA system."

?"The nursing care is horrible, orders were not carried out even though they were in the system, patients were very often left in dirty diapers over night, and nurses often complained about having to do their jobs."

?"Some [nurses] are excellent, some are scary incompetent and I worried about my patients when I left the hospital."

Nursing chief Huff said that she is proud of her staff, that many of them have won awards and that her 88-year-old father has received excellent care at the Dallas hospital. "I felt comfortable leaving my father in the care of these nurses," she said.

The Dallas medical center recorded 13,499 admissions last year, with an average daily patient census of 670.

Saddestpart is that I have to put the assholes on my CV/resume:(
 

Pliablemoose

Lifer
Oct 11, 1999
25,195
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Originally posted by: DivideBYZero
You must have contributed quite a lot....

It's a huge place, trying to change anything is remarkably like pissing into the wind.

Typical day in the ER, trying to negotiate a bed for a patient.

Me: "Hey, this is Pliablemoose in the ER, I have a rule out MI that the chief resident approved for admission to your ward."

Them: "There's no bed available."

me: But the Chief resident said everything was cool, approved & there should be a bed ready for my patient."

Them: "Nope"

me: "Can I talk to your charge nurse?"

Them: "She's busy"

me: "I can wait a little while."

15 minutes on hold in the freaking ER is an eternity, but I wait..... and wait and wait...

Them: "What do you want?"

me: "Are you the charge nurse?"

them "Yes."

me: "Who are you?"

them "unintelligible"

me: (realizing they'll nevr tell me their name & likely hang up if I push the issue) I have a rule out MI that the chief resident approved for admission to your ward, they said you had a bed"

them: "We don't"

me: "Could you please look?"

them: "ok"

on hold another 5-15 minutes.......

them, "We have a bed."

me: "Great, can I give report to the nurse that's going to take him?"

them "No, because:

A.) "The bed is dirty & houskeeping hasn't cleaned it yet (fvcking BS, I cleaned my own beds when I worked on the wards, and they're supposed to clean their own beds if housekeeping isn't available."

B.) " The nurse is: busy/dead/off the ward/stealing drugs/taking a crack break/a psychotic asshole that will come to the phone shortly after hell freezes over."

C.) "It's shift change, call back in 1-2 hours."

D.) If the charge nurse wan't particularly swift, she'd just hang up on me.

E.) "The Chief resident lied, we don't have any beds, the one I just told you about is really a joke bed to make you-all in the ER crazy"

Me: "Ok, I guess I'll call back later."

Repeat.... in 1 hour. Meanwhile for some reason, the ambulances and patients just keep coming... & the poor patient that needed a bed is 4 feet from me & heard everything I said...
:(
 

aswedc

Diamond Member
Oct 25, 2000
3,543
0
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My dad works at a VA hospital. He doesn't think its too bad, but the management is definately more interested in covering their asses than making it a better place. I think the system should be privatized...
 

mcveigh

Diamond Member
Dec 20, 2000
6,457
6
81
I thought my hospital was the worst! :)
we have a contract with the VA to do their sleep studies...it's scary how bad the communicatino is at the VA.
 

kehi

Diamond Member
Sep 18, 2000
3,357
0
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Damn, that is terrible. This is a complete disgrace to the those that have served and to the entire United States, and in the presidents home state nonetheless. Do VA's have JCAHO inspections? Did they lose approval?
 

mcveigh

Diamond Member
Dec 20, 2000
6,457
6
81
Originally posted by: kehi
Damn, that is terrible. This is a complete disgrace to the those that have served and to the entire United States, and in the presidents home state nonetheless. Do VA's have JCAHO inspections? Did they lose approval?

I don't think the VA does..but I really don't know.

jaco is a joke anyways my hospital passed and we had mold growing on the walls:roll:
 

crab

Diamond Member
Jan 29, 2001
7,330
19
81
I've spent altogether over a year of my life in hospitals...You don't even want me to get into it.

My mother (RN) worked at a nursing home for 15 years and left the industry entirely out of disgust.
 

AzNmAnJLH

Golden Member
Feb 26, 2002
1,785
1
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Time to outsource all the mediocre unskilled hospital jobs. Who should I contact to give them a business card? My company could make their facility 100% JCAHO, DOH, OSHA, and IG compliant within 3 months tops.
 

mcveigh

Diamond Member
Dec 20, 2000
6,457
6
81
Originally posted by: AzNmAnJLH
Time to outsource all the mediocre unskilled hospital jobs. Who should I contact to give them a business card? My company could make their facility 100% JCAHO, DOH, OSHA, and IG compliant within 3 months tops.

yes ....but for a price $$$$$

it comes down to money for most places.
 

Amused

Elite Member
Apr 14, 2001
56,713
17,211
146
Here is your preview of what national healthcare would look like.

Unfortunately, too many here will not make the connection and will continue to live in denial.
 

Pliablemoose

Lifer
Oct 11, 1999
25,195
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The article got picked up by the AP, it's even in the Guardian in the UK...

They are JCAHO accredited, but that's been a rubber stamp accrediatation for decades.

Originally posted by: Amused
Here is your preview of what national healthcare would look like.

Unfortunately, too many here will not make the connection and will continue to live in denial.

That's exactly right, the papers even held off on the story for a month & a half because it's a public health issue.

When Hillary was trying to push for national health care, they held the VA as an example of how it would work.

The one in Dallas is an abomination, I couldn't believe how fvcked up it was/is.

My favorite was the time I emailed my congressman & told her about an unsafe situation, I got told the remedy I suggested was impossible (locking the access doors to the ER) a year later a psych resident was assaulted so badly by a psych patient that he had permenant neurological damage & had to drop out of his residency program.

We heard some screaming & found a 300+ pound psych patient sitting on top of him, slamming the poor guy's head into a concrete floor over & over.

2 months later they installed locking doors, after the medical school told them they'd lose their affiliation with them unless they instituted a laundry list of changes..
 

kehi

Diamond Member
Sep 18, 2000
3,357
0
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My favorite was the time I emailed my congressman & told her about an unsafe situation, I got told the remedy I suggested was impossible (locking the access doors to the ER) a year later a psych resident was assaulted so badly by a psych patient that he had permenant neurological damage & had to drop out of his residency program.



That is some messed up sh#t :Q. I will be attending PA school starting this year so it is a wakeup call for me.

BTW: What does rubber stamp accrediatation mean?