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Healthcare Inspection – Review of Robotic Assisted General Surgery, Southern Arizona Health Care System, Tucson, Arizona

Report Information

Issue Date
Report Number
15-04651-81
VISN
State
Arizona
District
VA Office
Veterans Health Administration (VHA)
Report Author
Office of Healthcare Inspections
Report Type
Hotline Healthcare Inspection
Recommendations
0
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
OIG conducted an inspection in response to a complainant’s allegations regarding robotic assisted surgery performed by General Surgery physicians at Southern Arizona VA Health Care System in Tucson, Arizona. We did not substantiate that a surgeon selected a poor candidate for robotic-assisted low anterior resection surgery though the patient was medically complex and surgically challenging. While the type of surgical management may vary among surgeons, the decision to utilize robotic technique in the patient was within the discretion of the surgeon’s clinical judgment. We did not substantiate that a surgeon provided sub-standard surgical care for a patient. The patient experienced complications after surgery, but these same complications could have occurred if the patient had undergone a laparoscopic or open type procedure. We did not substantiate that a surgeon is a poor laparoscopic surgeon and needs additional training before performing robotic-assisted surgery. Facility surgeons who perform robotic-assisted low anterior resection surgery at the facility completed the requisite training, including being proctored for six surgical cases, and attended advanced courses for additional training. We did not substantiate the facility lacks Intensive Care Unit bed availability for post-operative recovery, but we determined bed flow issues may result in a physical bed shortage in the Intensive Care Unit at times. Four Rapid Process Improvement Workshops related to bed flow issues were completed and process improvement recommendations that were implemented have helped to move patients to appropriate levels of care and open Intensive Care Unit beds. We made no recommendations.
Recommendations (0)