Delays and Deficiencies in Management of Selected Radiology and Nuclear Medicine Outpatient Exams

The VA Office of Inspector General (OIG) conducted this review to determine if the Veterans Health Administration (VHA) completed radiology and nuclear medicine exam requests and follow-up care in a timely manner. The audit team also reviewed two related hotline allegations and determined if VHA managed canceled requests appropriately nationwide. The audit team estimated that 17 percent of routine exams and 25 percent of urgent exams were not completed within the required time frames. Reasons included staff and equipment shortages, issues with staff allocation, and insufficient monitoring of the scheduling process. Additionally, facility staff did not consistently follow radiology and nuclear medicine policy for canceled outpatient requests. Inappropriate cancellations can lead to delayed or incomplete exams and increase patient wait times. The audit team found that most follow-up care was completed appropriately. Facility staff either attempted to complete the recommended follow-up care with veterans or confirmed that they received it. The OIG made several recommendations to the under secretary for health to address management issues on the facility and regional levels. Among the recommendations were ensuring that facility staff evaluate the workload for scheduling exam requests and monitor requests that have been pending for more than seven days, implementing a mechanism to routinely audit canceled exam requests and take corrective action as needed, developing and implementing a plan for improving radiology and nuclear medicine oversight regionally, and creating a method for sharing new guidance with radiology and nuclear medicine leaders. The audit team also substantiated allegations of inappropriate exam cancellations at the James A. Haley and Iowa City VA medical centers. The issues were addressed in the general recommendations.