VA Health Care: Monitoring of Cardiac Surgery and Kidney Transplantation
HRD-88-70
Published: May 26, 1988. Publicly Released: Jun 14, 1988.
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Highlights
Pursuant to a congressional request, GAO reviewed the Veterans Administration's (VA) monitoring of its Cardiac Surgery Program and Kidney Transplant Program, focusing on whether VA: (1) developed adequate performance standards; (2) centers met these standards; and (3) adequately monitored centers' performance.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Veterans Administration | The Administrator of Veterans Affairs should direct the Chief Medical Director to require that a site visit be conducted at each cardiac surgery center that does not meet the mortality standards for a prescribed time period, such as 12 consecutive months. |
The Cardiac Surgery Consultants Committee received the criteria and recommended approval. The final draft criteria was presented to the full committee on June 5, 1989 and approved by the Chief Medical Director on June 16, 1989.
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| Veterans Administration | To better assess whether contract hospitals are providing cardiac surgery to veterans at an overall level consistent with VA standards, the Administrator of Veterans Affairs should require that the Chief Medical Director develop a procedure for collecting and monitoring these hospitals' utilization and mortality information for nonveterans as well as veterans. |
New sharing agreements have been modified to collect utilization data starting in October 1989.
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| Veterans Administration | The Administrator of Veterans Affairs should require the Chief Medical Director to: (1) adopt the HHS task force patient and kidney graft survival rates or establish alternative standards; and (2) regularly monitor the centers' performance against these standards. If a center does not show potential for meeting these standards, the Chief Medical Director should consider terminating the centers' kidney transplant activities. |
VA adopted HHS task force patient and kidney graft survival rates as performance standards. The Director of Surgical Services annually reviews the centers' performance against these standards. Centers' not meeting these standards will be considered for termination by the Chief Medical Director, according to the Director of Surgical Service.
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Topics
Organ and tissue transplantationCardiovascular diseasesHospital care servicesMonitoringMortalityPatient care servicesProgram managementQuality controlStandards evaluationSurgeryUrologic diseasesVeterans hospitals