Gastrointestinal consultation backlog reported at second east Georgia VA hospital

By WESLEY BROWN | The Augusta (Ga.) Chronicle | Published: January 29, 2014

The Charlie Norwood Veterans Affairs Medical Center in Augusta isn’t the only hospital of its kind in east central Georgia to delay consultations for gastrointestinal patients.

In 2013, health care administrators at the Carl Vinson Veterans Affairs Medical Center in Dublin, Ga., paid a discounted fee to have 61 patients receive colonoscopies and endoscopies at Fort Gordon’s Dwight D. Eisenhower Army Medical Center.

Wes Elliott, spokesman for the Army medical center, confirmed that the Fort Gordon hospital accepted the referrals through its general surgery wing as part of a sharing agreement it has with the Carl Vinson and Charlie Norwood VA medical centers to assist with backlogs.

He said the Army hospital’s gastrointestinal department did not accept the patients because of a lack of space.

“It’s one of our busier programs,” Elliott said of the Army hospital’s gastrointestinal department. “But I am not aware of any associated backlogs.”

The news of Georgia’s veterans in need of gastrointestinal procedures experiencing delays in both Dublin and Augusta – where 5,100 patients went without consultations between 2011 and 2012 – comes as The American Legion plans to host town hall meetings across the state today to discuss the quality of care being offered locally by the VA.

The advocacy group will meet in Augusta at 7 p.m. at Post 205 at 2102 Highland Ave.

Frank Jordan, spokesman for the Dublin VA, confirmed that the hospital sent 61 patients to Eisenhower for colonoscopies and endoscopies, but said such referrals were made as part of the hospital’s Georgia Federal Health care Executive Council initiative to “share vital resources for veterans and active-duty military.”

Elliott said the Eisenhower Army Medical Center was reimbursed in accordance with federal policies and that payment was based on the TRICARE Maximum Allowable Rate discount of 10 percent.

“All such screenings were routine based on standard clinical criteria,” Jordan said in an e-mail.

As of Tuesday, Jordan said the Dublin VA has no pending GI consults. He said that through active care by dedicated GI staff, the hospital prevented a backlog.

“To ensure the most efficient approach to Veterans’ GI needs and ensure the highest quality health care, Dublin has a GI nurse/RN to coordinate GI consults,” he said. “Dublin monitors Veterans’ GI needs and has arranged care in the community closer to where the Veteran lives and to avoid delays. Exceptions only occur to accommodate the express wishes of Veterans.”

While the Dublin VA used its Augusta partners in the past year because of backlog problems, Elliott and Jordan said that from 2011 to 2013, neither of their hospitals received any referrals for routine gastrointestinal issues from the Augusta VA.

According to an internal memo obtained by The Augusta Chronicle, the Augusta VA asked “non-VA care partner facilities” in September 2012 to assist in the reduction of consult delays.

Their collective participation – which was negotiated through fee agreements – was intended to create between 30 and 60 procedure opportunities per day.

Hospital spokesman Pete Scovill declined comment this week on how many patients were referred, during what time period they were sent into the community and to where they were directed.

A review initiated by the VA’s headquarters in Atlanta in August 2012 revealed a delay in 2,860 screenings, 1,300 surveillance and 340 diagnostic endoscopies.

Health care administrators at the Augusta VA said the hospital was able to resolve all delayed consultations between August 2012 and January 2014.

Among the steps the medical center stated in the memo that it took to correct the backlog included adding weekend clinics; leasing and purchasing 21 extra scopes; and hiring additional personnel to staff four full-time GI suites in two operating rooms to do as many as 90 procedures a day by mid-October.

American Legion organizers say each year, officials with the organization’s System Worth Saving Task Force visit about 15 VA medical centers nationwide to evaluate the quality of care being offered to veterans.

The public is invited to attend. Feedback from the meeting is used by the legion in formulating questions and discussion topics with key administrators, medical staff and patients at medical centers.

The Charlie Norwood Veterans Affairs Medical Center in Augusta, Ga.


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