Healthcare Inspection: Alleged Computed Tomography Scan Delays and Timekeeping Abuses Dayton VA Medical Center Dayton, Ohio.

摘要

The VA Office of Inspector General Office of Healthcare Inspections conducted an inspection in response to a complainants allegations that the Dayton VA Medical Center (facility) placed patients with stroke at risk for potential harm because computed tomography (CT) imaging was not staffed 24 hours a day, 7 days a week. The complainant specifically alleged that delays in obtaining CT scans after-hours reduced the patients chances of getting tissue plasminogen activator (tPA) therapy, often referred to as a clot buster drug. Additionally, the complainant alleged that a great deal of overtime money was paid to CT technologists for call coverage after-hours, when the CT section was not staffed. We did not substantiate the allegation that after-hours on-call staffing resulted in problematic delays in obtaining CT scans or provision of tPA therapy for acute stroke patients. As a supporting stroke facility, the facility promptly transfers or diverts patients acutely presenting with stroke symptoms to the community primary stroke center and does not provide CT scans or tPA therapy in these cases. While emergency clinicians were very clear about this process, some imaging staff were not. The facility convened a compliance review and, later, an Administrative Investigation Board (AIB) in response to concerns regarding overtime and timekeeping. The AIB found irregularities in the overtime paid for after-hours CT coverage, but did not substantiate that some timekeepers violated policies and procedures related to timekeeping and privacy.