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Capitol Health Call
January 8, 2014

GAO: VA Peer Review Process After Adverse Events Not Working

JAMA. 2014;311(2):128. doi:10.1001/jama.2013.285755

Department of Veterans Affairs (VA) medical centers are not using certain elements of the protected peer review process after an adverse event when they evaluate the role of individual clinicians in the event, reported the Government Accountability Office (GAO) in a report released December 3 (http://1.usa.gov/1cdddbK).

The GAO found in its visits to several VA medical centers that none adhered to all protected peer review policy elements selected for review, including timely completion of reviews and timely development of peer review triggers that signal the need for further assessment of a clinician’s care. The agency noted that from mid-2006 through 2009, the VA reported 101 surgical adverse events.