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Learning lessons continue in Marion VA case

Credentialing Resource Center Connection, January 14, 2010

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Dear readers,

Last week I experienced a case of deja-vu when I read about the Government Accountability Office’s (GAO) report, “VA HEALTH CARE: Improved Oversight and Compliance Needed for Physician Credentialing and Privileging Processes.” The report examines the mistakes that led to a higher than average death rate at the Veterans Affairs (VA) medical center in Marion, IL between October 2006 and March 2007. The GAO arrived at many of the same conclusions as the VA Office of Inspector General’s (OIG) official healthcare inspection report issued in January 2008; hence, my deja-vu.

Briefings on Credentialing readers will recall that the case was profiled in the November 2008 article, “Marion VA Medical Center problems and solutions: Lessons learned from an OIG investigation.” Some of the lessons explored in that article are worth revisiting in light of the new GAO report.

One such lesson is the role of the MSP in documenting and voicing concerns. Although some issues are seemingly beyond the control of an MSP—such as Marion’s problem of physicians underreporting the number of malpractice claims—there are other ways MSPs can support medical staff leaders in ensuring compliance.

If you see a red flag on an application, you can convey the seriousness of the problem to the appropriate people through phone calls, e-mails, and notes attached to the application. If there is a section in the medical staff bylaws that addresses the issue, including that citation in the communication will help convey the seriousness of the problem. Include a record of your communication efforts in the credentials folder and follow up as needed.

No medical staff is immune to credentialing problems, but by focusing on the lessons learned in cases such as the Marion VA case, medical staffs can avoid repeating problems.

Sincerely,

Emily Berry, associate editor

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