Review of Staffing and Access Concerns at the Mann-Grandstaff VA Medical Center Spokane, Washington

The VA Office of Inspector General (OIG) conducted a rapid response healthcare inspection to review staffing and access concerns at the Mann-Grandstaff VA Medical Center (facility), Spokane, Washington. Seven providers left the facility from early June through mid-July 2019; however, the OIG did not find the loss was unexpected or unusual. The provider losses were due to internal transfers, planned retirements, and resignations. The OIG found that access to some outpatient care started to decline around May 2019. As of August 2019, the percent of primary care new patient appointments completed less than 30 days from the created date decreased from more than 80 percent in April to less than 40 percent in August. The OIG team confirmed that the facility formed a multidisciplinary team to analyze the potential impact on patients, staff, and the facility at large, of closing the intensive care unit due to low utilization. As of late July 2019, the facility was temporarily utilizing one of its two operating rooms. The decision to curtail operating room utilization was the result of Sterile Processing Service staffing shortfalls and other deficiencies identified during a visit from the National Program Office for Sterile Processing (NPOSP). Facility leaders determined that a temporary reduction in operating room procedures and dental services to decrease the volume of items requiring sterile processing was in the best interest of patient safety. A dentist was functioning as the Acting Chief of Radiology. The previous Chief of Radiology voluntarily stepped down to fill a staff radiologist position. The Chief of Dental Service was detailed to the position of Acting Chief of Radiology based on previous leadership experience and qualifications. The OIG made two recommendations related to ensuring that patients have timely access to care and continued corrective actions regarding deficient areas identified in the NPOSP report.