Healthcare Inspection: Delays in Cancer Care West Palm Beach VA Medical Center West Palm Beach, Florida

摘要

The VA Office of Inspector General Office of Healthcare Inspections conducted an inspection to determine the validity of allegations of delayed cancer care at the West Palm Beach VA Medical Center, West Palm Beach, FL. The author reviewed allegations that patients did not receive timely treatment after a diagnosis of lung or renal cancer; these patients did not receive timely cardiac risk assessment prior to surgery; and facility management was aware of, but unresponsive to, these issues. They did not substantiate the allegation that lung cancer patients did not receive timely treatment. We found no delays in the initiation of treatment for lung cancer patients with a confirmed diagnosis, regardless of the treatment modality (surgery, chemotherapy, or Fee Basis radiation therapy). They substantiated the allegation that renal cancer patients faced delays in treatment. For those patients who were referred to another VA Medical Center for care, there was no mechanism in place to follow their progress and verify that treatment was provided. These patients faced significantly longer wait times for treatment than those patients whose treatment option was available at the West Palm Beach VA Medical Center. The authors also substantiated that management was aware of problems with timely renal cancer care for one patient, but made no effort to follow up on this. We did not substantiate that there were delays in obtaining cardiac risk assessment prior to patients surgery for lung or renal cancer. They made three recommendations. We recommended that the Medical Center Director ensure that formal processes are strengthened for tracking the timeliness of cancer care through the ongoing use of metrics and milestones, and ensure that processes are implemented to improve the coordination of care for patients referred to other VA Medical Centers for cancer treatment. We further recommended that the VISN Director require a review of surgical wait times for cancer patients at the Miami VA Medical Center. The VISN and Medical Center Directors concurred with our findings and recommendations. Several process improvements have been implemented and the Chief of Surgery at the Miami VA Medical Center reviewed surgical wait times for lung and renal cancer patients.