Sunday, January 22, 2012

Is the VA sterilizing its equipment?

1 patty murray

1 filner

Senator Patty Murray is the Chair of the Senate Veterans Affairs Committee. House Representative Bob Filner is the Ranking Member on the House Veterans Affairs Committee. They are calling attention to the need to ensure that medical equipment at the VA is sterilized.

For Immediate Release
January 19, 2012
Contact:
Murray: 202-224-2834
Filner: 202-225-9756


Murray, Filner Request GAO Review of VA's Sterilization of Reusable Medical Equipment Policies and Procedures

(Washington, D.C.) -- Today, U.S. Senator Patty Murray, Chairman of the Senate Committee on Veterans' Affairs, and Congressman Bob Filner (D-CA) sent a letter to Government Accountability Office (GAO) Comptroller Gene Dodaro expressing concern over reports of shortcomings in the sterilization of reusable medical equipment. In the letter, they urge the GAO to investigate whether VA's leadership is taking appropriate actions to address these problems across the system.

"On numerous occasions, VA has reported to Congress about the various investigations it has conducted and the problems these investigations have identified, which they claim have led to the development of new processes and procedures to reduce the risk of these problems reoccurring," Senator Murray and Congressman Filner said in the letter. "However, we continue to hear about the same types of quality of care incidents at VA medical facilities and we are concerned that this is an indication that VA is not effectively learning from these incidents and subsequently translating those lessons into system-wide improvements."
The full text of the letter follows:

January 19, 2012



The Honorable Gene L. Dodaro

Comptroller General of the United States

Government Accountability Office
441 G Street, NW
Washington, D.C. 20548

Dear Mr. Dodaro:

We know of repeated quality of care problems throughout the Department of Veterans Affairs (VA) health care system. Some of these problems, such as shortcomings in the sterilization of reusable medical equipment, reoccur with unacceptable frequency. This raises concerns as to whether VA's leadership is taking appropriate actions, including the appropriate disciplinary actions, to effectively address the problems across the system. On numerous occasions, VA has reported to Congress about the various investigations it has conducted and the problems these investigations have identified, which they claim have led to the development of new processes and procedures to reduce the risk of these problems from reoccurring. However, we continue to hear about the same types of quality of care incidents at VA medical facilities and we are concerned that this is an indication that VA is not effectively learning from these incidents and subsequently translating those lessons into system-wide improvements.

Therefore, we request that the Government Accountability Office (GAO) conduct a review of VA's processes and procedures for responding to quality of care incidents that occur within its health care system. Specifically, we request that GAO review the following:

1. What processes and procedures does VA use to respond to quality of care incidents that occur at its medical facilities, including quality assurance reviews and disciplinary actions? To what extent do these processes and procedures compliment and inform each other? What, if any, gaps or inconsistencies exist?

2. How does VA determine which processes and procedures to use to respond to quality of care incidents? What factors contribute to why certain processes and procedures are chosen by VA over others?

3. What challenges, if any, do VA staff face when using these processes and procedures?

4. To what extent are the processes and procedures carried out consistently across VA's health care system?

5. What data, if any, does VA systematically collect with regard to its employees' involvement in quality of care incidents, including clinicians and others? How, if at all, are these data trended and analyzed? To what extent are these data used to determine what actions to take in response to these incidents?

6. To what extent does VA use the data to identify opportunities for system-wide quality improvement?


As a follow-on to the above work, we also request that GAO perform an in-depth assessment of the extent to which VA medical facilities follow the processes and procedures used to respond to quality of care incidents.

Thank you for your work to improve the care and services our veterans receive. We look forward to reviewing your findings.

Sincerely,


PATTY MURRAY
Chairman Ranking Democratic Member
Senate Committee on Veterans' Affairs


BOB FILNER
Ranking Democratic Member
House Committee on Veterans Affairs
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