VA review finds radiology delays at NC medical center

Investigators with the U.S. Department of Veterans Affairs (VA) have discovered delays in the provision of radiology services at a VA medical center in North Carolina, including an average backlog of more than 1,300 orders for imaging exams.

The VA's Office of Inspector General (OIG) on October 4 issued the findings of its investigation into a complaint of a large backlog of radiology exams at W.G. (Bill) Hefner VA Medical Center (VAMC) in Salisbury. The OIG reported that the individual filing the complaint had submitted six allegations regarding delays at the Salisbury VAMC, including the existence of a large backlog of radiology orders.

The OIG was unable to substantiate five of the allegations, but it did substantiate the existence of a backlog of 3,300 pending orders for radiology exams at a specific point during 2014. After that time, the Salisbury VAMC made some progress in reducing the backlog but was unable to completely eliminate it, the OIG stated. The medical center averaged 1,358 pending orders for imaging exams from January 2014 through March 2016.

The facility's imaging service "was not effectively managing its pending radiology exam workload to ensure patients received timely exams," according to the report. What's more, some patients experienced "significant delays" in the completion of their exams.

OIG investigators reviewed the records of 15 patients who died before the completion of a total of 16 exams that had been ordered, but they weren't able to find a relationship between the delays and any deaths or adverse clinical outcomes.

The agency recommended that the Salisbury VAMC initiate a staff review of all unscheduled orders for radiology exams that are 30 days past the clinically indicated date, and make sure the exams are scheduled or cancel them. It also recommended that the center's director make unscheduled urgent and stat orders a priority and investigate whether any patients have been harmed by delays in their care.

Lastly, the OIG recommended that the director of the VA Mid-Atlantic Healthcare Network ensure that the Salisbury VAMC develop a plan to address the demand for radiology exams and make sure that patients have access to services in accord with Veterans Health Administration policy.

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