Veterans Administration's Health Care Quality Assurance Systems and Procedures

In response to a congressional request, testimony was given on the Veterans Administration's (VA) health care quality assurance systems and the degree to which they were implemented at the 13 VA medical centers which GAO visited, as well as the quality assurance activities of several central office organizations. To ensure that quality medical care is provided on a timely basis to all eligible veterans, each medical center is required to review the quality of care provided to its patients, and the VA central office reviews quality of medical center care and determines the effectiveness of their quality assurance programs. VA regulations require medical centers to conduct continuous monitoring, report and investigate patient injuries, ensure that resources are appropriately used, conduct studies of complex clinical problems, and review staff credentials. However, GAO found that the medical centers' quality assurance programs were limited in scope and were only partially in compliance with the regulations. The centers did not always determine whether appropriate health care services were provided, determine patterns and trends of medical care, and resolve systemic problems. In addition, GAO found that external reviews have not evaluated the effectiveness of the medical centers' quality assurance programs, and planned external reviews have not been conducted. The Medical Inspector is responsible for investigating specific allegations of perceived poor quality care, while the VA Inspector General receives allegations of fraud, waste, and mismanagement and investigates those which have merit, as well as overseeing the Medical Inspector's investigations.