Healthcare Inspection: Pulmonary Services and Quality of Care Issues North Florida/South Georgia Veterans Health System Gainesville, Florida.

摘要

The purpose of this review was to determine the validity of allegations regarding quality of care issues and the adequacy of pulmonary services at the North Florida/South Georgia Veterans Health System in Gainesville, Florida. We did not substantiate the allegation that there were four full-time pulmonary fellows funded while only one fellow was at the medical center at any given time. We found 4 funded positions for pulmonary disease and critical care medicine, and we found a pool of 12 fellows who worked various schedules, which was the equivalent of 4 full-time positions. We substantiated the allegation that one fellow was responsible for covering inpatient consultations (consults), inpatient and most outpatient bronchoscopies, and the medical intensive care unit (MICU). The system conducted an internal assessment of pulmonary fellows responsibilities and recommended realignment of duties, which resulted in increased pulmonary coverage for MICU and inpatient consults. We substantiated the allegation that on weekends one fellow managed critically ill patients in the VA MICU and also covered Shands Hospital at the University of Florida. However, we found that the medical center had back-up assistance from other physicians if needed, and there was no evidence that pulmonary coverage on weekends negatively affected patient care.