More than a year ago, the VA Medical Center in Washington, DC, did so poorly on inspections that the federal government declared a state of emergency and sacked its central director. As of mid-2018, conditions have not improved.
If anything, conditions got worse.
The long list of glaring and unacceptable problems will haunt and horrify you. These include:
- Rusty surgical instruments
- Contaminated and congested “sterile” storage areas
- Constant shortage of essential supplies, such as vascular patches, oxygen tubes, and incision staplers
- A leadership culture that places blame on subordinates, denying primary responsibility
- Weather increase in preventable infections, including drug-resistant staph (MRSA)
- Oh, and a blood bank that’s recklessly hot
A group of employees within this VA, who wish to remain anonymous to protect themselves from retaliation, wrote a letter to VA administrative leaders, including our promising leader, Robert Wilkie.
“We ask you, our respected leaders, to stop this cover-up and incompetence, to really care and keep America’s promise to her heroes,” they wrote. “Enough is enough.”
They received a form by e-mail. Good start.
Some of these problems could be solved without too much hassle. Closer scrutiny of on-call staff, for example, could dramatically improve standards of cleanliness and care.
This is especially relevant if they are hired as entrepreneurs rather than as employees of the hospital proper. Since such employees may report entirely to another company, they probably weren’t given a second thought.
Supplies are likely on under-order, often lost and possibly stolen. We recently published an article about tracking failures in Ohio VA locations as well, so there may be similar issues in DC.
The medical center’s constant need to borrow everything from ultrasound probes to “bone material” from a nearby private hospital is not only horrible, but it also speaks to poor planning by the quality assurance (QA) department.
In response to the rampant spread of MRSA and other superbugs, hospitals across the country are said to be well served by coating metal surfaces with a thin layer of copper in some high traffic areas. Door handles and handrails would be particularly good candidates for such treatment.
The ionic structure of copper kills bacteria membranes, regardless of drug resistance. The effect is chemical, like salting a slug; the organism simply cannot survive on a copper surface. Ancient people knew about this property of metal, while most of us today have forgotten about it.
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Copper is expensive and tarnishes easily, but it can be particularly useful in hospitals where cleanliness is routinely overlooked. Of course, these are minor fixes at the surface level.
The real problem here is the obnoxious and complacent leadership culture. The Office of the Inspector General (OIG) found that “a sense of futility permeated offices on many levels”. In other words, those responsible do not act as if they are responsible. Failure is inevitable and is not under human control.
It’s a problem with a much more difficult solution than hiring new custodians, keeping better inventory, or even throwing money at the wall to see what sticks. The psyche of the people is shattered and as a result more than ten thousand veterans remain in danger of death.