DANVILLE — The Veterans Affairs Illiana Health Care System has changed its level of inpatient surgeries, performing only standard — rather than intermediate — procedures.
Veterans who need intermediate or complex surgeries will be referred to the VA at Indianapolis or one of the community health-care providers.
The change was implemented in January, and there have been no problems, officials said. No jobs have been affected.
“In support of our mission, this enhances the quality and safety of our care,” said Michael E. Hamilton, director of the Illiana system, “and enables us to direct resources more effectively by utilizing services available elsewhere in the community.”
Illiana had been doing intermediate surgeries, such as complete joint replacement.
However, the Department of Veterans Affairs began as assessment of all levels of surgery in 2007. At that point, Hamilton said, “Our leadership identified a need to reassess all our surgical programs and infrastructure across the country.”
The department conducted a review to determine what levels of operations may be performed at each of its 112 medical centers.
Based on an expert work group’s review of surgical programs from June 2009 to March, each medical center was assigned a surgical complexity level of standard, intermediate or complex.
Veterans Affairs has 66 hospitals that will perform complex surgeries, 33 that will perform intermediate procedures and 13 that will perform standard procedures.
The VA determined that the Illiana system will do only standard procedures, such as foot and ankle surgery.
That hasn’t presented any problems, said Doug Shouse, administrative assistant to the director. Last year, there were 922 inpatient surgeries performed in the Illiana system, and only 70 — or less than 9 percent — were intermediate. Half of those 70 procedures were joint replacements (hip and knee).
Hospitals with a standard complexity rating may perform surgeries requiring limited infrastructure, such as hernia repair, cholecystecomy, urologic procedures and ENT surgeries.
Those with an intermediate rating have more substantial infrastructure and may perform surgeries such as colon resections, repairs of abdominal aortic aneurysms and complete joint replacement.
A rating of complex requires specialized infrastructure and allows hospitals to perform more intricate operations, such as cardiac surgery, craniotomies and total pancreatectomies.
A veteran in the Illiana system who needs more complex procedures, such as total joint replacement, will undergo them through contractual arrangements with qualified area health-care providers or the nearest appropriate VA facility.
Each of VA’s 21 networks of hospitals and clinics has developed a surgical strategic plan based on its medical centers’ designated complexity levels.
The Illiana system has a hospital in Danville and five outpatient clinics in Decatur, Springfield, Peoria and Mattoon, and West Lafayette, Ind. In that system, more the 31,000 veterans were treated last year, Shouse said.
VA’s initiative is the first of its kind by a large, integrated health-care system and is designed to ensure that all inpatient surgeries for veterans are performed under the safest possible conditions at facilities that have the resources to support them.
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