Report Summary

Title: Ophthalmology Equipment and Related Concerns at the James A. Haley Veterans’ Hospital, Tampa, Florida
Report Number: 19-07095-253 Download
Issue Date: 11/7/2019
City/State: Tampa, FL
VA Office: Veterans Health Administration (VHA)
Report Author: Office of Healthcare Inspections
Report Type: Healthcare Inspection
Release Type: Unrestricted

The VA Office of Inspector General (OIG) conducted a healthcare inspection to assess allegations involving ophthalmology equipment-related maintenance and repair issues and other concerns at the James A. Haley Veterans’ Hospital in Tampa, Florida.

Ophthalmology equipment is often expensive and delicate; maintenance and repairs require detailed precision. The facility has a Medical Equipment Management Program (MEMP) to ensure operational reliability, assess and minimize risks, and respond to failures of medical equipment. In Veterans Health Administration facilities, equipment maintenance activities, including preventive maintenance, are the responsibility of the Biomedical Section.

The OIG did not substantiate allegations related to specific ophthalmology equipment. Preventive maintenance was performed according to the manufacturers’ recommendations and the facility’s MEMP plan. The team found no evidence that biomedical support specialists lacked competencies to perform assigned tasks.

The OIG was unable to determine whether eye clinic procedures were canceled due to equipment issues. Available documentation did not include the reason a community referral was made. The OIG substantiated an increase in eye care-related community care consults; however, the increased volume was largely the result of changes in access to ambulatory surgery services and clinic scheduling practices.

The OIG substantiated that Prosthetic and Sensory Aids Service took four to six weeks to issue a purchase order, resulting in patients waiting six to eight weeks for eyeglasses. The two facility purchasing agents, designated to process purchase orders for eyeglasses, retired.

The OIG was unable to determine if facility leaders had not responded to complaints for at least 15 years. Facility leaders made management decisions in consideration of financial priorities, which excluded preventive maintenance contracts.

The OIG made four recommendations related to Biomedical Section staff work order documentation; equipment corrective maintenance timeliness and communication; timeliness of eyeglass purchase order processing; and addressing the backlog of open eyeglass purchase order requests.