VA Leadership Vows to Fix Problems Identified at Marion VA Medi...(evaluated to be able to address issues i...),Health

-- Credentialing: Credentialing is the process by which health care organizations screen and evaluate medical providers in terms of licensure, education, training, experience, competence and health status. The facility, at times, failed to document its consideration of important credentialing information such as malpractice claims; and documentation related to the verification of licensure, registration and certification requirements was not always done in a timely manner.

-- Privileging: Privileging is the process by which physicians are granted permissions to practice and to perform various diagnostic and therapeutic procedures. The Inspector General found instances in which surgeons performed procedures they were not authorized to perform. The medical center also failed to adequately consider past performance and outcomes in decisions whether to renew surgeons' permission to continue to perform certain procedures. In addition, both the Inspector General and the Medical Inspector's reports criticize the facility for allowing surgeries to be performed that were more complex than the facility could handle based on its staff and capabilities. Concerns include the fact the medical center did not have 24-hour coverage in respiratory therapy, pharmacy and radiology.

-- Facility Leadership: The Inspector General believed there were warnings on many of the problems identified in NSQIP's site visit, including NSQIP's own data, which Marion's leadership should have acted upon before others discovered the problem. According to the IG, though, most of this information was "not disseminated to other VHA managerial entities such as VISN 15 (the facility's parent network) or VA headquarters in Washington, DC."

VA is examining each of these areas, not only at Marion but throughout the Department's health care system, to ensure these types of issues are not present at other facilities and to
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