Report recommends changes at Iowa City VA hospital

Hospital criticized for management lapses

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A report concludes that quality medical care has not been compromised, but changes are recommended for the Iowa City VA Health Care System, stemming from a review conducted amid allegations of a “vindictive” atmosphere that could affect patient care.

The Department of Veterans Affairs Office of the Inspector General posted the report online Wednesday.

Sen. Chuck Grassley, R-Iowa, sent the office a letter in March, forwarding complaints his office had received from patients and employees.

Nearly 1,000 employees responded to the Inspector General’s survey request, Grassley’s office noted.

"These whistleblowers fear retaliation and characterize the working atmosphere as 'vindictive,' which prevents many employees from voicing concerns to superiors,” Grassley wrote in March. "Morale has been described as 'terrible,' causing many employees to consider looking elsewhere for employment,"

The Inspector General’s Office investigated allegations that concerns of the staff had been largely ignored. The review found that "high quality medical care has been maintained,” the report stated. “However, a pervasive lack of support for staff problem-solving is a potential threat to patient safety, and that several process deficiencies were identified.”

Those deficiencies stemmed from a prolonged period when key leadership positions were held by individuals on a temporary basis, according to the report, when decisions were delayed or never made, “and a highly competent professional staff was frustrated by the persistent ineffectiveness of senior leadership.”

Spokeswoman Valerie Buckingham said Iowa City VA Director Barry Sharp has been serving as interim director at the Minneapolis VA Health Care Center since Jan. 3.

Dawn Oxley, associate director  Patient Care Services/nurse executive, has served as acting director in Iowa City.

Buckingham said Sharp will return to Iowa City to resume his regular post on Tuesday.

“We’re studying the report,” Buckingham said, when contacted Wednesday afternoon.

The report’s recommendations include having the Veterans Integrated Service Network director – who oversees a group of hospitals in several states - ensure that leaders take appropriate action in response to identified problems and communicate action plans to staff.

Leaders should also clarify organizational lines of authority and responsibility and improve Environment of Care and Pharmacy management, according to the recommendations.

Cathy Gromek, spokeswoman for the VA Inspector General’s Office in Washington, D.C., said the hospital has 90 days to provide an update.

“We look to close our recommendations within a year,” she said, but noted that the office keeps asking for updates until the hospital takes action that meets those recommendations.

In a written statement, Grassley said he appreciated being alerted to the problems.

“The key for the management is to immediately take steps to address the problems laid out by the Inspector General before patient care is impacted,” he said.

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