The VA relied on experts’ assessments of appropriate equipment and personnel needed for each type of surgery, followed up by nine months of on-site reviews at each of its 112 hospitals, to come up with the following levels for VA hospitals:
- Complex surgeries: 66 hospitals are allowed to perform more intricate operations, such as cardiac surgery, craniotomies and total pancreatectomies.
- Intermediate surgeries: 33 hospitals are allowed to perform surgeries such as colon resections, repairs of abdominal aortic aneurysms and complete joint replacement.
- Standard surgeries: 13 hospitals are allowed to perform inpatient surgeries requiring limited infrastructure, such as hernia repair, cholecystecomy, urologic procedures and ENT surgeries.
The VA has also decided that five facilities conducting surgeries at the intermediate level will henceforth be limited to the standard level. These facilities are in Alexandria, La., Beckley, W.V., Fayetteville, N.C., Danville, Ill., and Spokane, Wash. It said these changes would require only 0.1 percent of surgeries at these facilities to be referred to another provider.
A cardiologist at 66-bed Spokane Veterans Affairs Medical Center told the in Spokane Spokesman Review the new categories were prompted by surgical deaths in 2007 at a VA hospital in Marion, Ill.
“There were no mal-occurrences at Spokane VA that precipitated any of this,” the cardiologist said, adding that the panel that decided to limit Spokane surgeries “looked at possible complications, no matter how remote.”
The VA release said the surgical review program “will be continuous, expand to include standards for outpatient surgery and provide a key tool for ongoing health system improvement.” It said the VA’s 21 hospital networks have also developed “a surgical strategic plan” to “strengthen quality, safety and service.”
Read the release from the Department of Veterans Affairs on VA hospitals.
Read the Spokesman Review’s report on VA hospitals.
