Healthcare Inspection – Follow-Up Review Access to Urology Service, Phoenix VA Health Care System, Phoenix, Arizona

OIG conducted a healthcare inspection to follow up on concerns regarding access to care in the urology service at the Phoenix VA Health Care System (system) in Phoenix, Arizona. We limited our inspection to determining whether a delay in care was associated with adverse patient impact. During OIG’s 2014 review of system scheduling practices and wait times, we reported that large numbers of patients referred for urological evaluation and/or treatment experienced significant delays. The delays involved obtaining an appointment, scheduling follow-up, and/or receiving authorizations for non-VA urology care (see: Review of Alleged Patient Deaths, Patient Wait Times, and Scheduling Practices at the Phoenix VA Health Care System, Phoenix, Arizona; [Report No. 14-02603-267, August 26, 2014]). OIG’s Office of Healthcare Inspections opened an expanded review focusing on access to urology care at the system. An interim report Review of Phoenix VA Health Care System’s Urology Department Phoenix, Arizona; (Report No. 14-00875-112, January 28, 2015), detailed our findings regarding incomplete documentation for 759 urology patients and the potential impact on care. In Review of Access to Urology Service at the Phoenix VA Health Care System, Phoenix, Arizona; (Report No. 14-00875-03, October 15, 2015), we found a significant urology staffing shortage, inconsistent non-VA urology provider documentation of patient care, and untimely care to patients needing urological services. We committed to reviewing the records and management of the 759 patients once the Veterans Health Administration provided us with the necessary documentation. This report details these findings. We determined that 148 (20 percent) of the 759 patients experienced delays in getting new evaluations or follow-up appointments. When a delay was identified, we assessed the impact of that delay on the patient’s care. From a clinical standpoint, we found that none of the patients were adversely impacted by a delay in care.