|Title:||Healthcare Inspection - Clinical Privileges and Airway Management Marion VA Medical Center, Marion, Illinois|
|VA Office:||Veterans Health Administration (VHA)
|Report Author:||Office of Healthcare Inspections
|Report Type:||Healthcare Inspections
OHI received four complaints between October 2011 and January 2012 regarding the clinical practice of two physicians. In February 2012, Senator Richard J. Durbin forwarded additional allegations concerning one of the physicians.
In the care of one patient, the risk of complications requiring urgent intervention should have been discussed with the patient as part of the informed consent process prior to a procedure, at which time the patient’s therapeutic preferences could have been clarified. We identified no deficiencies in quality of care for two other patients. We also found that a physician who was hired after not being in clinical practice for many years was granted clinical privileges with the understanding that his competence would be confirmed by direct observation. However, competence was never documented for invasive procedures that he subsequently performed. We recommended that the facility Director ensure that VHA and local policies are followed when initial clinical privileges are granted, peer review processes comply with VHA policy, staff with demonstrated competence in airway management are available 24 hours a day, 7 days a week, an Intensive Care Unit (ICU) Director is appointed, and the facility adheres to local policy regarding the use of ICU beds. The Acting VISN Director and facility Director agreed with our findings and recommendations and provided acceptable action plans.