Comprehensive Healthcare Inspection of the Mann-Grandstaff VA Medical Center in Spokane, Washington

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report provides a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the Mann-Grandstaff VA Medical Center and multiple clinics in Idaho, Montana, and Washington. The inspection covers key clinical and administrative processes that are associated with promoting quality care. This inspection focused on Leadership and Organizational Risks; COVID-19 Pandemic Readiness and Response; Quality, Safety, and Value; Medical Staff Privileging; Medication Management: Long-Term Opioid Therapy for Pain; Mental Health: Suicide Prevention Program; Care Coordination: Life-Sustaining Treatment Decisions; Women’s Health: Comprehensive Care; and High-Risk Processes: Reusable Medical Equipment.At the time of the OIG site visit, the leadership team had worked together for about one month and had vacancies in two of four positions. Employee satisfaction survey results for the medical center and leaders were similar to or higher than Veterans Health Administration averages. Patients generally appeared satisfied with the care provided, but indicated opportunities to improve appointment scheduling for female veterans. The OIG’s review of accreditation findings, sentinel events, and disclosures did not identify any substantial organizational risk factors, but the OIG noted potential risks with the medical center’s expected electronic health record system implementation. Leaders were knowledgeable about selected data used in Strategic Analytics for Improvement and Learning models and should continue to take actions to sustain and improve performance.The OIG issued 13 recommendations for improvement in five areas:(1) Quality, Safety, and Value• Protected peer reviews• Root cause analyses(2) Medical Staff Privileging• Focused professional practice evaluations(3) Mental Health• Patient follow-up• Suicide prevention safety plans• Community outreach activities• Suicide risk training(4) Women’s Health• Gynecologic care coverage• Women veterans health committee• Quality assurance data collection and tracking• Women veterans program manager duties(5) High-Risk Processes• Annual risk analysis• Competency assessments