Review of Delays in Clinical Consult Processing at VA Boston Healthcare System, Massachusetts

The VA Office of Inspector General (OIG) conducted a healthcare inspection in response to a complaint that staff at the VA Boston Healthcare System in Massachusetts inappropriately discontinued consults (healthcare providers use consults to request an opinion, advice, or expertise regarding patients’ specific problems). The OIG reviewed a sample of discontinued consults and determined that none of these consults were processed inappropriately. The OIG verified that facility leaders and managers monitored and analyzed consult data, communicated with service leaders about identified concerns, implemented clinical and administrative processes for performance improvement, and monitored the results. The Veterans Integrated Service Network (VISN) provided oversight for tracking patients’ access to care, managing consults, and other facility performance measures. VISN leaders conducted monthly management meetings to review patients’ access to care and consult processing concerns, as well as performance data with facility leaders. Facility managers provided monthly reports on access to care and consult processing to a VISN manager, who tracked facility action plans related to access to care. Based on interviews and review of facility committee minutes and action plans, the OIG concluded that facility leaders were actively engaged and had effective performance improvement and consult management processes in place. Therefore, the OIG made no recommendations.